Healthcare Provider Details

I. General information

NPI: 1548536261
Provider Name (Legal Business Name): PREMIER MEDICAL ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2012
Last Update Date: 03/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 SAN DIMAS ST BUILDING A SUITE 250
BAKERSFIELD CA
93301-2284
US

IV. Provider business mailing address

3838 SAN DIMAS ST BUILDING A SUITE 250
BAKERSFIELD CA
93301-2284
US

V. Phone/Fax

Practice location:
  • Phone: 661-323-5300
  • Fax: 661-323-5455
Mailing address:
  • Phone: 661-323-5300
  • Fax: 661-323-5455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT L LAUGHLIN
Title or Position: PRINCIPAL OFFICER
Credential: MD
Phone: 661-323-5300