=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164633053
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUN PACIFIC HEALTH MEDICAL GROUP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/24/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8501 CAMINO MEDIA SUITE 200
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93311-1354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-665-1800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8501 CAMINO MEDIA SUITE 100
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93311-1354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-665-1800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BILLING MANAGER
-----------------------------------------------------
Name | MRS. STEPHANIE ELDERBAUM
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 661-213-4157
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC24224
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | A65257
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------