Kevork Bouldoukian, M.D., Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A55931 Issued in CA

Legal business name

KEVORK BOULDOUKIAN, M.D., INC.

Practice address

2128 Truxtun Ave
Bakersfield, CA 93301-3702

Phone

(661) 633-9080

Fax

(661) 633-9081

NPI assigned

Jan 24, 2012

Last updated

Dec 31, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kevork Bouldoukian, M.D.NPI 1720020464

Title

Owner

Phone

(661) 633-9080

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevork A. Bouldoukian, M.D.

  • Internal Medicine Physician
  • Bakersfield, CA
  • NPI 1720020464
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356912000000",
    "number": "1619248523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2128 TRUXTUN AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933013702",
            "telephone_number": "661-633-9080",
            "fax_number": "661-633-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 TRUXTUN AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933013702",
            "telephone_number": "661-633-9080",
            "fax_number": "661-633-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVORK BOULDOUKIAN, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-24",
        "last_updated": "2012-12-31",
        "status": "A",
        "authorized_official_last_name": "BOULDOUKIAN",
        "authorized_official_first_name": "KEVORK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-633-9080",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A55931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "GF042A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Keshav R Khadka
• Saima Khairi

• Internal Medicine Physician in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.