| Coffee Surgery Center, Llc | |
|
2525 Eye St Suite 100 Bakersfield CA 93301-2064 | |
| (209) 338-8368 | |
| Not Available |
| Full Name | Coffee Surgery Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2525 Eye St, Bakersfield, California |
| Authorized Official Name and Position | Vickie A. Kasprzyk (PRESIDENT) |
| Authorized Official Contact | 2093388368 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coffee Surgery Center, Llc 2525 Eye St Suite 100 Bakersfield CA 93301-2064 Ph: (662) 131-4813 | Coffee Surgery Center, Llc 2525 Eye St Suite 100 Bakersfield CA 93301-2064 Ph: (209) 338-8368 |
| NPI Number | 1457643405 |
|---|---|
| Provider Enumeration Date | 05/10/2011 |
| Last Update Date | 02/08/2012 |
| Medicare PECOS PAC ID | 2466734546 |
|---|---|
| Medicare Enrollment ID | O20170125001477 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457643405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | PENDING (* (Not Available)) | Secondary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | PENDING (* (Not Available)) | Primary |
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