MEDICARE: MR. JOHNNY L TRIPLETT MD

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
1	207L00000X	Anesthesiology Physician	A53390	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245210368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHNNY L TRIPLETT MD

Provider Business Mailing Address
First Line	:	3811 WYNDHAM AVE
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93313
Country	:	US
Telephone Number	:	661-834-3929
Fax Number	:	661-834-2925

Provider Business Practice Location Address
First Line	:	4674 EAST BARKER WAY
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90814
Country	:	US
Telephone Number	:	562-930-9059
Fax Number	:	562-930-9059

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	01/10/2011

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