Provider Demographics
NPI:1679235998
Name:GAUDIN ANESTHESIA, A PROFESSIONAL NURSING CORPORATION
Entity Type:Organization
Organization Name:GAUDIN ANESTHESIA, A PROFESSIONAL NURSING CORPORATION
Other - Org Name:GAUDIN ANESTHESIA SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:GAUDIN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:337-315-2294
Mailing Address - Street 1:24820 ORCHARD VILLAGE
Mailing Address - Street 2:STE- A #236
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15243 VANOWEN ST STE 202
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3645
Practice Address - Country:US
Practice Address - Phone:337-315-2294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-13
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty