# GAMEDAY SPORTS MEDICINE ACADEMY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CALIFORNIA INSTITUTE OF COSMETIC AND RECONSTRUCTIVE SURGERY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1689228462
- **Legal business name:** CALIFORNIA INSTITUTE OF COSMETIC AND RECONSTRUCTIVE SURGERY
- **Authorized official:** VIPUL RAMAN DEV (OWNER/PRESIDENT)
- **Authorized official phone:** (661) 327-2101

## Contact information

- **Practice address:** 3101 GILMORE AVE STE 100, BAKERSFIELD, CA 93308-6342
- **Practice address phone:** (661) 327-2101
- **Practice address fax:** (661) 327-2554
- **Mailing address:** 2901 SILLECT AVE STE 201, BAKERSFIELD, CA 93308-6373
- **Mailing address phone:** (661) 706-9444
- **Mailing address fax:** (661) 327-2554

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080S0010X | Pediatric Sports Medicine Physician | — | NULL | Yes |
| 2080S0010X | Pediatric Sports Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/30/2019
- **Last updated:** 07/30/2019