Organization
SHAFTER PEDIATRICS
Active
Organization
SHAFTER PEDIATRICS
Active
Parent organization
SHAFTER PEDIATRICS
Other names
Elmo pediatrics & family walk-in clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHAFTER PEDIATRICS
Authorized official
DR. AYODEJI ADETAYO AYENI M.D. (MEDICAL DIRECTOR)
(661) 364-5244
Entity
Organization
Contact information
Practice address
501 MUNZER ST, SUITE C, SHAFTER, CA 93263-2042
(661) 630-5274
(661) 630-5290
Mailing address
P.O. BOX 22694, BAKERSFIELD, CA 93390-2694
(661) 630-5274
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
552863
MEDICAL BOARD OF CALIFORNIA
CA
Enumeration date
08/13/2021
Last updated
12/29/2023
Update your record
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