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Organization
TRUXTUN PSYCHIATRIC MEDICAL GROUP
Active
Organization
TRUXTUN PSYCHIATRIC MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. S A MANOHARA M.D. (OWNER)
(661) 323-6410
Entity
Organization
Contact information
Practice address
6001 TRUXTUN AVE, SUITE 160, BAKERSFIELD, CA 93309-0679
(661) 323-6410
(661) 323-7631
Mailing address
6001 TRUXTUN AVE, SUITE 160, BAKERSFIELD, CA 93309-0679
(661) 323-6410
(661) 323-7631
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
A34791
CA
103T00000X
Psychologist
A41677
CA
103T00000X
Psychologist
A44584
CA
103T00000X
Psychologist
A50719
CA
103T00000X
Psychologist
C30492
CA
103T00000X
Psychologist
C43345
CA
Other
Enumeration date
04/09/2007
Last updated
08/22/2020
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