Organization
KIDNEY CENTER A MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLINE WONG MD (OWNER OPERATOR)
(661) 869-2600
Entity
Organization
Contact information
Practice address
3543 SAN DIMAS ST, SUITE B, BAKERSFIELD, CA 93301-1605
(661) 869-2600
(661) 869-2003
Mailing address
PO BOX 11959, BAKERSFIELD, CA 93389-3959
(661) 869-2600
(661) 869-2003
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G75701
CA
208M00000X
Hospitalist Physician
G75701
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ04314Z
—
CA
Enumeration date
01/09/2007
Last updated
08/28/2015
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