Provider Demographics
NPI:1447641410
Name:BAKERSFIELD PROSTHETICS & ORTHOTICS CENTER, INC
Entity type:Organization
Organization Name:BAKERSFIELD PROSTHETICS & ORTHOTICS CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:DHOKIA
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:661-281-2127
Mailing Address - Street 1:PO BOX 1928
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93303-1928
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:323 S LEXINGTON ST
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-3693
Practice Address - Country:US
Practice Address - Phone:661-720-9293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAKERSFIELD PROSTHETICS & ORTHOTICS CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-02-12
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1629101621Medicaid
CA1154352391Medicaid
CA4013980002Medicare NSC
CA1154352391Medicaid