| Kevork Bouldoukian, M.d., Inc. | |
|
2128 Truxtun Ave Bakersfield CA 93301-3702 | |
| (661) 633-9080 | |
| (661) 633-9081 |
| Full Name | Kevork Bouldoukian, M.d., Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2128 Truxtun Ave, Bakersfield, California |
| Authorized Official Name and Position | Kevork Bouldoukian (OWNER) |
| Authorized Official Contact | 6616339080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevork Bouldoukian, M.d., Inc. 2128 Truxtun Ave Bakersfield CA 93301-3702 Ph: (661) 633-9080 | Kevork Bouldoukian, M.d., Inc. 2128 Truxtun Ave Bakersfield CA 93301-3702 Ph: (661) 633-9080 |
| NPI Number | 1619248523 |
|---|---|
| Provider Enumeration Date | 01/24/2012 |
| Last Update Date | 12/31/2012 |
| Medicare PECOS PAC ID | 7214192061 |
|---|---|
| Medicare Enrollment ID | O20120629000413 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619248523 | NPI | - | NPPES |
| GF042A | Other | CA | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A55931 (California) | Primary |
| Provider Name | Kevork Md Bouldoukian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720020464 PECOS PAC ID: 8921263773 Enrollment ID: I20120629000438 |
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