Individual
DR. JEFFREY KYLE BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8329 BRIMHALL RD, SUITE 801, BAKERSFIELD, CA 93312-2243
(661) 695-8385
(661) 679-6801
Mailing address
8329 BRIMHALL RD, SUITE 801, BAKERSFIELD, CA 93312-2243
(661) 695-8385
(661) 679-6801
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A11715
CA
207RR0500X
Rheumatology Physician
Primary
20A11715
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101340
—
CA
01
—
1265783948
GROUP NPI
CA
01
—
CB206701
CMS NORIDIAN
CA
01
—
DT5405
RR MEDICARE PTAN
—
01
—
GU585A
CMS NORIDIAN
CA
Enumeration date
04/13/2007
Last updated
08/02/2022
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