Provider Demographics
NPI:1083148142
Name:VAMM NURSING ANESTHETISTS INC
Entity Type:Organization
Organization Name:VAMM NURSING ANESTHETISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAHONY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:805-786-4878
Mailing Address - Street 1:5 HOLLAND
Mailing Address - Street 2:SUITE 101
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2566
Mailing Address - Country:US
Mailing Address - Phone:949-588-2190
Mailing Address - Fax:949-588-2199
Practice Address - Street 1:5 HOLLAND
Practice Address - Street 2:SUITE 101
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2566
Practice Address - Country:US
Practice Address - Phone:949-588-2190
Practice Address - Fax:949-588-2199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-16
Last Update Date:2017-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty