Provider Demographics
NPI:1578392585
Name:MOMI, RAKESH (OD)
Entity type:Individual
Prefix:
First Name:RAKESH
Middle Name:
Last Name:MOMI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13414 GIRO DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-6646
Mailing Address - Country:US
Mailing Address - Phone:661-213-3000
Mailing Address - Fax:661-213-3101
Practice Address - Street 1:9820 BRIMHALL RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2787
Practice Address - Country:US
Practice Address - Phone:661-213-3000
Practice Address - Fax:661-213-3101
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT35798-TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist