Sonoma Trail Medical Services, a Med Corp

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

SONOMA TRAIL MEDICAL SERVICES, A MED CORP

Practice address

555 S 7TH Ave
Barstow, CA 92311-3043

Phone

(469) 401-2386

NPI assigned

Oct 12, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles T Mitchell

Title

Officer

Phone

(469) 401-2386

Specialties & licenses 3

Addresses

Tax ID family

Sonoma Trail Medical Services a Med Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sonoma Trail Medical Services, a Med Corp

  • Emergency Medicine Physician
  • Redding, CA
  • NPI 1578934923
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444608000000",
    "number": "1912378340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98576",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891938576",
            "telephone_number": "469-401-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S 7TH AVE",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923113043",
            "telephone_number": "469-401-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONOMA TRAIL MEDICAL SERVICES, A MED CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "469-401-2386"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Smith
• Madison P Smith
• Tamieka Smith
• Cheryl Smothers
• Lauren E Soles
• Allison Spears
• Specialty Infusions Nursing Care
• Spectrum Optimal Care, LLC
• Vernon G Spidle, MPT
• Tyler Steele

• Emergency Medicine Physician in Barstow, CA
• Providers in Barstow, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.