Healthcare Provider Details
I. General information
NPI: 1194180968
Provider Name (Legal Business Name): SOUND PHYSICIANS EMERGENCY MEDICINE OF SOUTHERN CALIFORNIA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/22/2015
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2615 CHESTER AVE
BAKERSFIELD CA
93301-2014
US
IV. Provider business mailing address
120 BRENTWOOD COMMONS WAY STE 510
BRENTWOOD TN
37027-2028
US
V. Phone/Fax
- Phone: 661-395-3000
- Fax:
- Phone: 253-682-6024
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAURA
FALL
Title or Position: MANAGER
Credential:
Phone: 253-682-6040