Provider Demographics
NPI:1538286661
Name:CMB ANESTHESIA ASSOCIATES INC
Entity Type:Organization
Organization Name:CMB ANESTHESIA ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAROSS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:702-795-8808
Mailing Address - Street 1:PO BOX 60596
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89160-0596
Mailing Address - Country:US
Mailing Address - Phone:702-795-8808
Mailing Address - Fax:702-795-8809
Practice Address - Street 1:1785 E SAHARA AVE STE 320
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3717
Practice Address - Country:US
Practice Address - Phone:702-795-8808
Practice Address - Fax:702-795-8809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVWCHFFMedicare PIN