Basic Information
| Provider Information | |||||||||
| NPI: | 1962664441 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUND INPATIENT PHYSICIANS MEDICAL GROUP INC | ||||||||
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| OtherOrganizationName: | SOUND INPATIENT PHYSICIANS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 60000 FILE 30754 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2536826011 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1200 B GALE WILSON BLVD | ||||||||
| Address2: | |||||||||
| City: | FAIRFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945333552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074293600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2008 | ||||||||
| LastUpdateDate: | 06/02/2009 | ||||||||
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| AuthorizedOfficialLastName: | KODJABABIAN | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 2536821710 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | C.O.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.