Provider Demographics
NPI:1336318070
Name:DOEVE, KARNADI PETER (CRNA)
Entity Type:Individual
Prefix:MR
First Name:KARNADI
Middle Name:PETER
Last Name:DOEVE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:MR
Other - First Name:PETER
Other - Middle Name:
Other - Last Name:DOEVE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:530 DOHENY CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-8459
Mailing Address - Country:US
Mailing Address - Phone:951-283-5509
Mailing Address - Fax:
Practice Address - Street 1:530 DOHENY CIR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-8459
Practice Address - Country:US
Practice Address - Phone:951-283-5509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3724367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered