Provider Demographics
NPI:1831290345
Name:ANESTHESIA AND PAIN SPECIALISTS, A MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:ANESTHESIA AND PAIN SPECIALISTS, A MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:530-241-5499
Mailing Address - Street 1:PO BOX 990279
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96099-0279
Mailing Address - Country:US
Mailing Address - Phone:530-241-5499
Mailing Address - Fax:530-241-5677
Practice Address - Street 1:1238 WEST ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0415
Practice Address - Country:US
Practice Address - Phone:530-241-5499
Practice Address - Fax:530-241-5677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65834207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA050076410OtherRAILROAD MEDICARE
CAG65834OtherLICENSE
CA00G658340Medicaid
CA00G658340Medicaid
CAD37875Medicare UPIN
CA00G658342Medicare ID - Type UnspecifiedIND #
CAZZZ04116ZMedicare ID - Type UnspecifiedGRP #