Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 20A10167 | CA |
NPI | 1013169572 |
---|---|
Provider Name | Dr. Michael Darin Niedens |
First Address | Bakersfield, CA 93312-6385 |
Second Address | Bakersfield, CA 93305-4144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2008 |
Last Update Date | 26/03/2012 |