Provider Demographics
NPI:1336571553
Name:BACHTLER, THOMAS FRANCIS (CRNA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:FRANCIS
Last Name:BACHTLER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 W BONITA AVE
Mailing Address - Street 2:#117
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4123
Mailing Address - Country:US
Mailing Address - Phone:815-212-0985
Mailing Address - Fax:
Practice Address - Street 1:870 W BONITA AVE
Practice Address - Street 2:#117
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4123
Practice Address - Country:US
Practice Address - Phone:815-212-0985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA739312163W00000X
CANA4440367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse