Provider Demographics
NPI:1457399933
Name:CALIFORNIA ANESTHESIA ASSOCIATES MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:CALIFORNIA ANESTHESIA ASSOCIATES MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-417-1812
Mailing Address - Street 1:PO BOX 10429
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92658-0429
Mailing Address - Country:US
Mailing Address - Phone:714-415-4050
Mailing Address - Fax:714-415-4053
Practice Address - Street 1:2801 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1737
Practice Address - Country:US
Practice Address - Phone:562-933-2000
Practice Address - Fax:562-933-1336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ54349ZOtherBLUE SHIELD
CAGR0052780Medicaid
CAZZZ53042ZOtherBLUE SHIELD
CAZZZ52990ZOtherBLUE SHIELD
CAZZZ53041ZOtherBLUE SHIELD
CACD2528Medicare PIN
CAZZZ53042ZOtherBLUE SHIELD
CAZZZ53041ZOtherBLUE SHIELD
CACR0902Medicare PIN