| Vipmd | |
|
2901 Sillect Ave Ste 201 Bakersfield CA 93308-6373 | |
| (661) 327-2101 | |
| (661) 327-2554 |
| Full Name | Vipmd |
|---|---|
| Speciality | Internal Medicine |
| Location | 2901 Sillect Ave Ste 201, Bakersfield, California |
| Authorized Official Name and Position | Ty Heckman (MANAGER) |
| Authorized Official Contact | 6613272101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vipmd 2901 Sillect Ave Ste 201 Bakersfield CA 93308-6373 Ph: (661) 327-2101 | Vipmd 2901 Sillect Ave Ste 201 Bakersfield CA 93308-6373 Ph: (661) 327-2101 |
| NPI Number | 1124521018 |
|---|---|
| Provider Enumeration Date | 03/16/2018 |
| Last Update Date | 06/12/2023 |
| Medicare PECOS PAC ID | 5698106771 |
|---|---|
| Medicare Enrollment ID | O20200505000410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124521018 | NPI | - | NPPES |
| Provider Name | Julie Christine Pruett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639587579 PECOS PAC ID: 5294778262 Enrollment ID: I20050609001156 |
| Provider Name | Vipul Raman Dev |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1891702122 PECOS PAC ID: 2466474382 Enrollment ID: I20051220000612 |
| Provider Name | Daniel R Krauchuk |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1114234440 PECOS PAC ID: 3870741622 Enrollment ID: I20120919000761 |
| Provider Name | Idalberto Zaldivar Galves |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407332919 PECOS PAC ID: 6901215029 Enrollment ID: I20210430002184 |
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