Provider Demographics
NPI:1609175165
Name:CENCAL ANESTHESIA AND NURSING INC.
Entity Type:Organization
Organization Name:CENCAL ANESTHESIA AND NURSING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CYRUS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:559-436-0871
Mailing Address - Street 1:PO BOX 3109
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93650-3109
Mailing Address - Country:US
Mailing Address - Phone:559-436-0871
Mailing Address - Fax:559-436-5221
Practice Address - Street 1:1395 W LACEY BLVD
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5904
Practice Address - Country:US
Practice Address - Phone:559-436-0871
Practice Address - Fax:559-436-5221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty