Provider Demographics
NPI:1649459124
Name:DESAI, KIRIT (MD)
Entity type:Individual
Prefix:
First Name:KIRIT
Middle Name:
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1139
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1139
Mailing Address - Country:US
Mailing Address - Phone:661-371-2796
Mailing Address - Fax:661-438-1746
Practice Address - Street 1:2901 SILLECT AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-6370
Practice Address - Country:US
Practice Address - Phone:661-323-8384
Practice Address - Fax:661-864-1279
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38150207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA060028377OtherRAILROAD MEDICARE
CA953511288OtherTAX ID
CA00A381503OtherPTAN
CAA88447Medicare UPIN
CA060028377OtherRAILROAD MEDICARE