Basic Information
| Provider Information | |||||||||
| NPI: | 1114128006 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3733 SAN DIMAS ST | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933011407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003535400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3409 CALLOWAY DR UNIT 601 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6615891200 | ||||||||
| FaxNumber: | 6615897200 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2007 | ||||||||
| LastUpdateDate: | 08/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | NP10568 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363A00000X | 55237 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.