Healthcare Provider Details

I. General information

NPI: 1114128006
Provider Name (Legal Business Name): MICHAEL W REED NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 08/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3409 CALLOWAY DR UNIT 601
BAKERSFIELD CA
93312
US

IV. Provider business mailing address

3733 SAN DIMAS ST
BAKERSFIELD CA
93301-1407
US

V. Phone/Fax

Practice location:
  • Phone: 661-589-1200
  • Fax: 661-589-7200
Mailing address:
  • Phone: 800-353-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number55237
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP10568
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: