Good Shepherd Anesthesia Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A119375 Issued in CA

Legal business name

GOOD SHEPHERD ANESTHESIA INC

Practice address

8525 Gibbs Dr
Ste 208
San Diego, CA 92123-1755

Phone

(858) 495-0971

Fax

(858) 495-0991

NPI assigned

Apr 21, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Mark R Poblete, M.D.

Title

President

Phone

(858) 495-0971

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492732800000",
    "number": "1285169888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34120",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895334120",
            "telephone_number": "858-495-0971",
            "fax_number": "858-495-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8525 GIBBS DR",
            "address_2": "STE 208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231755",
            "telephone_number": "858-495-0971",
            "fax_number": "858-495-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD ANESTHESIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-21",
        "last_updated": "2017-04-21",
        "status": "A",
        "authorized_official_last_name": "POBLETE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-495-0971",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A119375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yesenia Gonzalez
• Yibel Gonzalez
• Edgar Manuel Gonzalezgomez, IDC
• Ashley Vanessa Gonzali
• Kevin Gooch, IDC
• Lori Corrine Good, DDS
• Taylor Good
• Tida Good, R.N.
• Ashley Kristen Goodacre, PA-C
• Andrew Raymond Goodall, PHARMD

• Anesthesiology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; 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.