Provider Demographics
NPI:1114128006
Name:REED, MICHAEL W (NP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:W
Last Name:REED
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3733 SAN DIMAS ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1407
Mailing Address - Country:US
Mailing Address - Phone:800-353-5400
Mailing Address - Fax:
Practice Address - Street 1:3409 CALLOWAY DR UNIT 601
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312
Practice Address - Country:US
Practice Address - Phone:661-589-1200
Practice Address - Fax:661-589-7200
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP10568363L00000X
CA55237363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner