Provider Demographics
NPI:1861449423
Name:METROPOLITAN ANESTHESIA CONSULTANTS, INC
Entity Type:Organization
Organization Name:METROPOLITAN ANESTHESIA CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-929-7229
Mailing Address - Street 1:5530 BIRDCAGE ST
Mailing Address - Street 2:STE 145
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:2288 AUBURN BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821
Practice Address - Country:US
Practice Address - Phone:916-929-7229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0044560Medicaid
CAZZZ09883ZOtherBLUE SHIELD OF CALIFORNIA
CAZZZ31657ZMedicare PIN
CAGR0044560Medicaid