Organization Active NPI

Tobias Anesthesia a Professional Nursing Corporation

  • Certified Registered Nurse Anesthetist
  • Colton, CA
National Provider Identifier
1184330722
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
TOBIAS ANESTHESIA A PROFESSIONAL NURSING CORPORATION
Practice address
1850 E Washington St Ste a
Colton, CA 92324-4621
Phone
(909) 835-4278
NPI assigned
Jan 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nick Perrenoud, CRNA
Title
Owner
Phone
(949) 588-2190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1850 E Washington St Ste a
Colton, CA 92324-4621

Mailing address

5 Holland Ste 101
Irvine, CA 92618-2568
Phone (949) 588-2190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230301002970 CA Part B Supplier - Clinic/Group Practice 4587037197 Receives reassigned benefits from 3 practitioners
Practice locations: Colton, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1184330722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HOLLAND STE 101",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182568",
            "telephone_number": "949-588-2190",
            "fax_number": "949-588-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E WASHINGTON ST STE A",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244621",
            "telephone_number": "909-835-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOBIAS ANESTHESIA A PROFESSIONAL NURSING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "PERRENOUD",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-588-2190",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.