Anesthesia Management Services of California Inc
Organization Active NPI Anesthesiology Physician · Ukiah, CA
NPI 1003458704 · NPPES record last updated Oct 14, 2019
Key facts
- NPI
- 1003458704
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- ANESTHESIA MANAGEMENT SERVICES OF CALIFORNIA INC
- Practice address
- 275 Hospital Dr
Ukiah, CA 95482-4531 - Phone
- (707) 463-3111
- Fax
- (707) 463-7339
- NPI assigned
- Oct 14, 2019
- Organization subpart
- No
Authorized official
- Name
- Samuel Thibodeaux
- Title
- President
- Phone
- (319) 331-0621
Practitioners 20
-
Ronald E Guth, M.D.
-
John Juve, CRNA
-
Krishneel Anand Lall, CRNA
-
Frederick A Lodge, M.D.
-
Josette Janine Salas, CRNA
-
Samuel J Thibodeaux, CRNA
-
Brian R. Knopp, CRNA, BSN, MSN
-
Kevin M Knopp, CRNA
-
Eugene Alfred McGough, CRNA
-
Vann Miller, CRNA
-
Joshua Reed Torman, CRNA
-
Barbara Lynne Wertz, CRNA
-
Richard Lee Fidler II, CRNA, CRNP, MSN
-
Gabriel Mullins, CRNA
-
Kenneth Dewey Childers Jr., C.R.N.A.
-
Edward Steven Herrera, CRNA
-
Robert Russell Ray II, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200206002375 | CA | Part B Supplier - Clinic/Group Practice | 0840626040 |
Receives reassigned benefits from 20 practitioners Practice locations: Ukiah, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes | ||
| Certified Registered Nurse Anesthetist |
367500000X |
Addresses
Primary practice location
275 Hospital Dr
Ukiah, CA 95482-4531
Mailing address
PO Box 34120
Reno, NV 89533-4120
Phone (775) 747-5050
Other providers in Ukiah, CA
- Lara C Anderson
- Sara Marlene Anderson
- Andrew I. Corbett, D.D.S Inc.
- Clifford Leon Andrews
- Gary Wyatt Andrus
- Catherine Mara Anglen
- Tess Antonetti
- Anna Marie Antonowich
- Anna Anttila
- Josefina Anzilotti-Batis
All providers in Ukiah, CA · Anesthesiology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.