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Organization
PETER S. ELLIS, M.D., INC.
Active
Organization
PETER S. ELLIS, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER STEVEN ELLIS M.D. (OWNER)
(661) 327-4647
Entity
Organization
Contact information
Practice address
420 34TH ST, BAKERSFIELD, CA 93301-2237
(661) 327-4647
(661) 326-8507
Mailing address
5505 VIA SORENTO, BAKERSFIELD, CA 93306-9567
(661) 373-7503
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0104110
—
CA
Enumeration date
12/27/2006
Last updated
02/26/2008
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