Basic Information
Provider Information
NPI: 1588638399
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: IPE
FirstName: JOSEPH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2635 G ST
Address2:  
City: BAKERSFIELD
State: CA
PostalCode: 933012813
CountryCode: US
TelephoneNumber: 6616331500
FaxNumber: 6616332700
Practice Location
Address1: 465 W PUTNAM AVE
Address2:  
City: PORTERVILLE
State: CA
PostalCode: 932573320
CountryCode: US
TelephoneNumber: 5597841110
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/16/2006
LastUpdateDate: 10/06/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA72752CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
05008656601CARAILROAD MEDICAREOTHER
00A72752105CA MEDICAID


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