Provider Demographics
NPI:1376596650
Name:AN ANESTHESIA AND PAIN MANAGEMENT MEDICAL CORPORATION
Entity Type:Organization
Organization Name:AN ANESTHESIA AND PAIN MANAGEMENT MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-745-3112
Mailing Address - Street 1:PO BOX 5668
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-1668
Mailing Address - Country:US
Mailing Address - Phone:707-745-3112
Mailing Address - Fax:707-745-9076
Practice Address - Street 1:1208 E 5TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-3502
Practice Address - Country:US
Practice Address - Phone:707-748-7248
Practice Address - Fax:707-745-9076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA197547100OtherUS DEPT OF LABOR
CAZZZ02512ZOtherBLUE SHIELD
CAGR0090670Medicaid
CAZZZ02512ZOtherBLUE SHIELD