NPIMap

Organization Active NPI

Sandeep S Walia, MD, a Professional Medical Corporation

  • Ophthalmology Physician
  • Bakersfield, CA
National Provider Identifier
1821629650
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SANDEEP S WALIA, MD, A PROFESSIONAL MEDICAL CORPORATION
Practice address
215 China Grade Loop
Bakersfield, CA 93308
Phone
(661) 393-2331
Fax
(661) 393-6284
NPI assigned
Jan 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Authorized official

Name
Mr. Sandeep S Walia, MDNPI 1750791661
Title
Owner
Phone
(661) 393-2331

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

215 China Grade Loop
Bakersfield, CA 93308

Mailing address

215 China Grade Loop
Bakersfield, CA 93308
Phone (661) 393-2331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200512001901 CA Part B Supplier - Clinic/Group Practice 2567893399 Receives reassigned benefits from 7 practitioners
Practice locations: Bakersfield, CA

National Provider Directory

National Provider Directory

Locations

11901 Bolthouse Dr
Bakersfield, CA 93311
Phone (661) 393-3231

11901 Bolthouse Dr
Ste 300
Bakersfield, CA 93311
Phone (661) 393-2331

215 China Grade Loop
Bakersfield, CA 93308
Phone (661) 393-2331

11901 Bolthouse Dr
Ste 300400
Bakersfield, CA 93311

215 China Grade Lop
Pasadena, CA 91110

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1821629650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 CHINA GRADE LOOP",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93308",
            "telephone_number": "661-393-2331",
            "fax_number": "661-393-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 CHINA GRADE LOOP",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93308",
            "telephone_number": "661-393-2331",
            "fax_number": "661-393-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDEEP S WALIA, MD, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "WALIA",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-393-2331",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "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 Jan 30, 2020; 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.