Provider Demographics
NPI:1750348256
Name:SOUTHWEST SURGICAL CENTER OF BAKERSFIELD LP
Entity type:Organization
Organization Name:SOUTHWEST SURGICAL CENTER OF BAKERSFIELD LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHARFF
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:205-545-2572
Mailing Address - Street 1:201 NEW STINE RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-2659
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 NEW STINE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-2659
Practice Address - Country:US
Practice Address - Phone:661-397-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
490004733Medicare PIN
CA05C0001342Medicare PIN