# MARVIN J. DERRICK

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Bakersfield Varicose Vein Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679775951
- **Authorized official:** DR. MARVIN J DERRICK M.D. (OWNER)
- **Authorized official phone:** (661) 377-8346

## Contact information

- **Practice address:** 3838 SAN DIMAS ST, STE A100, BAKERSFIELD, CA 93301-2284
- **Practice address phone:** (661) 377-8346
- **Practice address fax:** (661) 327-0921
- **Mailing address:** 3838 SAN DIMAS ST, STE A100, BAKERSFIELD, CA 93301-2284
- **Mailing address phone:** (661) 377-8346
- **Mailing address fax:** (661) 327-0921

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/31/2007
- **Last updated:** 06/12/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00G478550 | — | CA |