Organization
SAN JOAQUIN VALLEY PULMONARY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MO ZAHIRUDDIN (ADMINISTRATOR)
(661) 327-3743
Entity
Organization
Contact information
Practice address
5801 TRUXTUN AVE, BAKERSFIELD, CA 93309-0609
(661) 327-3747
(661) 616-3237
Mailing address
5801 TRUXTUN AVE, BAKERSFIELD, CA 93309-0609
(661) 327-3747
(661) 616-3237
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ15299Z
MEDICARE PTAN
CA
Enumeration date
06/07/2006
Last updated
08/03/2021
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