Provider Demographics
NPI:1366463762
Name:SCURLOCK, WILLIAM BRUCE (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BRUCE
Last Name:SCURLOCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21393
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-1393
Mailing Address - Country:US
Mailing Address - Phone:661-324-0500
Mailing Address - Fax:661-324-0600
Practice Address - Street 1:2400 BAHAMAS DR STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0746
Practice Address - Country:US
Practice Address - Phone:661-324-0500
Practice Address - Fax:661-324-0600
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG68082207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G680820Medicaid
CA00G680825Medicare PIN
CAZZZ15999ZMedicare PIN
CAZZZ21367ZMedicare PIN
CAZZZ34009ZMedicare PIN
CA00G680821Medicare PIN
CA050070731Medicare PIN
CAZZZ15998ZMedicare PIN
CAZZZ21365ZMedicare PIN
CA00G680820Medicaid
CA00G680824Medicare PIN
CAZZZ21366ZMedicare PIN
CAF34546Medicare UPIN
CA00G680822Medicare PIN
CA00G680823Medicare PIN
CA00G680826Medicare PIN