| Anti-aging & Wellness Center | |
|
4000 Stockdale Hwy Ste D Bakersfield CA 93309-2059 | |
| (661) 325-7452 | |
| (661) 325-7456 |
| Full Name | Anti-aging & Wellness Center |
|---|---|
| Speciality | Family Medicine |
| Location | 4000 Stockdale Hwy, Bakersfield, California |
| Authorized Official Name and Position | Shivinder S Deol (PRESIDENT) |
| Authorized Official Contact | 6613257452 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anti-aging & Wellness Center 4000 Stockdale Hwy Ste D Bakersfield CA 93309-2059 Ph: (661) 325-7452 | Anti-aging & Wellness Center 4000 Stockdale Hwy Ste D Bakersfield CA 93309-2059 Ph: (661) 325-7452 |
| NPI Number | 1124328273 |
|---|---|
| Provider Enumeration Date | 10/22/2010 |
| Last Update Date | 09/16/2015 |
| Medicare PECOS PAC ID | 1254525819 |
|---|---|
| Medicare Enrollment ID | O20101028000417 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124328273 | NPI | - | NPPES |
| 080004729 | Other | PTAN | |
| 84411017 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A37723 (California) | Primary |
| Provider Name | Shivinder Singh Deol |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558447250 PECOS PAC ID: 1355308396 Enrollment ID: I20101028000497 |
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