NPIMap

Organization Active NPI

Vinod C Bhan

Doing business as Mid Valley Anesthesia

  • Certified Registered Nurse Anesthetist
  • Stockton, CA
National Provider Identifier
1184707242
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA41 Issued in CA
Legal business name
VINOD C BHAN
Doing business as
Mid Valley Anesthesia
Practice address
1805 N California St
Suite 101
Stockton, CA 95204-6037
Phone
(209) 956-7725
Fax
(209) 948-9321
NPI assigned
Oct 23, 2006
Last updated
Feb 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Authorized official

Name
Vinnie C Bhan, CRNA
Title
Owner
Phone
(209) 956-7725

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA41 CA Primary

Addresses

Primary practice location

1805 N California St
Suite 101
Stockton, CA 95204-6037

Mailing address

1144 Norman Dr
Suite 102
Manteca, CA 95336-5925
Phone (209) 956-7725

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ03666ZOtherCAGROUP PTAN

Other names 1

  • MID VALLEY ANESTHESIA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060207000405 CA Part B Supplier - Clinic/Group Practice 1759396195 Receives reassigned benefits from 14 practitioners
Practice locations: Stockton, CA

National Provider Directory

National Provider Directory

Locations

1144 Norman Dr
Ste 102
Manteca, CA 95336
Phone (209) 823-1152

1805 N California St
Ste 101
Stockton, CA 95204
Phone (209) 948-3241

1805 N California St
Ste 1010
Stockton, CA 95204
Phone (209) 948-3241

1805 N California St
Ste 101A
Stockton, CA 95204
Phone (209) 948-3241

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613088000000",
    "number": "1184707242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 NORMAN DR",
            "address_2": "SUITE 102",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953365925",
            "telephone_number": "209-956-7725",
            "fax_number": "209-823-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST",
            "address_2": "SUITE 101",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046037",
            "telephone_number": "209-956-7725",
            "fax_number": "209-948-9321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINOD C BHAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A",
        "authorized_official_last_name": "BHAN",
        "authorized_official_first_name": "VINNIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-956-7725",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA41",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "ZZZ03666Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MID VALLEY ANESTHESIA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MID VALLEY ANESTHESIA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.