Elite Anesthesia Medical Group Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

FNP 30520 Issued in CA

Legal business name

ELITE ANESTHESIA MEDICAL GROUP INC

Practice address

9400 N Name Uno
Gilroy, CA 95020-3528

Phone

(408) 848-2000

NPI assigned

May 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark M Ahn, M.D.

Title

President

Phone

(800) 883-7243

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

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

• Amitabh Mohan Mathur, MD

  • Anesthesiology Physician
  • Hollister, CA
  • NPI 1932173986
  NPD (past)

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435363200000",
    "number": "1255382248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1000",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 N NAME UNO",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950203528",
            "telephone_number": "408-848-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE ANESTHESIA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2015-06-27",
        "status": "A",
        "authorized_official_last_name": "AHN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-883-7243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "FNP 30520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0093550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pat Egan
• Berika Egberuare
• Christiana Kelechi Eje
• Edith Elder, P.T.
• Christina Anne Eliopoulos
• Veronica Elizondo
• Rachael Ellis
• Morgan Nicole Ellwood
• Emergency Physicians Associates Gilroy PC
• Wendy Emerson, AMFT

• Anesthesiology Physician in Gilroy, CA
• Providers in Gilroy, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.