Unknown Individual – Internal Medicine Physician, NPI 1083073407

Unknown Individual is a healthcare provider. based in Bakersfield, California. specializing in Internal Medicine Physician. They hold a License No. A152377 (CA). The NPI Number for Unknown Individual is 1083073407

Main info

Organization
Inactive
12 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1083073407
Phone
(661) 326-2202
Address
1700 MOUNT VERNON AVE
Deactivation Date
28 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6613262000
Graduation Year
2014 (12 years ago)
PAC ID
5092059469
Group Practice PAC ID
4688964521
Professional Enrollment ID
I20181212001321
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Mount Vernon Avenue, Bakersfield, Kern County, California, 93307, United States

    BAKERSFIELD, CA 933064018

    Phone: (661) 326-2202

    Fax: (661) 862-7612

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $96.

Total Amount is formed as General ($96) + Research ($0) + Ownership ($0) = $96.

Last reported payment date: 2024-09-18 • Largest payer in this snapshot: ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) ($38).

Total Amount

$96

General + Research + Ownership

Payments

5

Total payment records

General Amount

$96

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 93306)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688964521View full group profile
NameSpecialtyState
-NY
-CA
General SurgeryNY
-CA
Nephrology, Internal MedicineCA
-CA
Internal MedicineCA
Internal MedicineWV
Nurse PractitionerCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1083073407 — is the standard way to identify this listing.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Bakersfield, California may find Unknown Individual in results; validate coverage separately.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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