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NPI Code Detail

MEDICARE: AJAY DESAI M.D.

MEDICARE: AJAY DESAI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistG85497CA
22085R0001XRadiation Oncology PhysicianG85497CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G85497OTHERCALICENSE

General Provider Information

NPI Number : 1124015706
Entity Type Code : Individual
Provider Name (Legal Business Name) : AJAY DESAI M.D.
Provider Business Mailing Address
First Line : 10608 PETALO DR
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93311-2284
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6501 TRUXTUN AVE
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93309-0633
Country : US
Telephone Number : 661-322-2206
Fax Number : 661-327-7027
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2005
Last Update Date : 05/25/2021

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