Individual provider Active NPI

Svetozar Stefan Stukovsky, MD

  • Family Medicine Physician
  • Bakersfield, CA
National Provider Identifier
1790971703
Registry record updated Sep 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A30646 Issued in CA
Practice address
12312 Arbor Park Place
Bakersfield, CA 93311
Phone
(661) 664-9970
NPI assigned
Sep 24, 2007
Last updated
Sep 24, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A30646 CA Primary

Addresses

Primary practice location

12312 Arbor Park Place
Bakersfield, CA 93311

Mailing address

12312 Arbor Park Place
Bakersfield, CA 93311
Phone (661) 664-9970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A30646CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1790971703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12312 ARBOR PARK PLACE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93311",
            "telephone_number": "661-664-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12312 ARBOR PARK PLACE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93311",
            "telephone_number": "661-664-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUKOVSKY",
        "first_name": "SVETOZAR",
        "middle_name": "STEFAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-24",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A30646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.