Provider Demographics
NPI:1033155015
Name:COMMUNITY ANESTHESIA MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:COMMUNITY ANESTHESIA MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MONTOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-942-0101
Mailing Address - Street 1:PO BOX 1750
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93539-1750
Mailing Address - Country:US
Mailing Address - Phone:661-942-0101
Mailing Address - Fax:661-723-5031
Practice Address - Street 1:43830 10TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4826
Practice Address - Country:US
Practice Address - Phone:661-940-1346
Practice Address - Fax:661-940-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0105600Medicaid
CA199369200OtherU S DEPT OF LABOR
CAC17667OtherRAILROAD MEDICARE
CAZZZ56645ZOtherBLUE SHIELD
CAZZZ56645ZOtherBLUE SHIELD