Healthcare Provider Details

I. General information

NPI: 1982650271
Provider Name (Legal Business Name): SOUTH BAY EMERGENCY MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 M ST
MERCED CA
95340-2813
US

IV. Provider business mailing address

111 N SEPULVEDA BLVD SUITE 210
MANHATTAN BEACH CA
90266-6861
US

V. Phone/Fax

Practice location:
  • Phone: 209-384-6480
  • Fax: 209-384-6710
Mailing address:
  • Phone: 310-379-2134
  • Fax: 310-379-4856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. MARK ROBERT BELL
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 310-379-2134