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General NPI Number Information
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NPI Number | 1003920935
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Entity Type | Organization
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Legal Business Name | SOUTH WEST PEDIATRICS A MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6001 BLDG. A TRUXTUN AVENUE STE. 180
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0679
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Country | US
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Telephone | 661-322-8687
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Fax | 661-325-4505
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Provider Business Mailing Address
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Address Line | 6001 BLDG. A TRUXTUN AVENUE STE. 180
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0679
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Country | US
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Telephone | 661-322-8687
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Fax | 661-325-4505
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Authorized Official
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Title or Position | INSURANCE BILLER
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Name | MISS KRISTINA ANN WHITMORE
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Credential |
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Telephone | 661-322-8687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | A043422
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License Number State | CA
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