Provider Demographics
NPI:1386980415
Name:PINNACLE EMERGENCY PHYSICIANS OF BAKERSFIELD, A PROFESSIONAL CORP
Entity type:Organization
Organization Name:PINNACLE EMERGENCY PHYSICIANS OF BAKERSFIELD, A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BURSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:626-447-0296
Mailing Address - Street 1:PO BOX 661972
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91066-1972
Mailing Address - Country:US
Mailing Address - Phone:626-447-0296
Mailing Address - Fax:626-447-6057
Practice Address - Street 1:2215 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3602
Practice Address - Country:US
Practice Address - Phone:661-632-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty