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: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 S OAK AVE
OAKDALE CA
95361-3519
US

IV. Provider business mailing address

1222 DEMONBREUN ST STE 1601
NASHVILLE TN
37203-7092
US

V. Phone/Fax

Practice location:
  • Phone: 209-847-3011
  • Fax:
Mailing address:
  • Phone: 253-682-6024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA FALL
Title or Position: MANAGER
Credential:
Phone: 253-682-6040