Provider Demographics
NPI:1497735773
Name:VOLK, JOHN EDWARD (CRNA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:EDWARD
Last Name:VOLK
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2239 PAMO RD
Mailing Address - Street 2:P.O. BOX 2431
Mailing Address - City:RAMONA
Mailing Address - State:CA
Mailing Address - Zip Code:92065-7619
Mailing Address - Country:US
Mailing Address - Phone:760-789-8726
Mailing Address - Fax:
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1098
Practice Address - Country:US
Practice Address - Phone:619-532-7169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3319367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered