Organization Active NPI

Sierra Nevada Anesthesia Medical Assoc Inc

  • Anesthesiology Physician
  • Grass Valley, CA
National Provider Identifier
1285737239
Registry record updated Dec 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
FNP 25717 Issued in CA
Legal business name
SIERRA NEVADA ANESTHESIA MEDICAL ASSOC INC
Practice address
155 Glasson Way
Grass Valley, CA 95945-5723
Phone
(530) 274-6000
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2013

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

Authorized official

Name
Dr. William John Rose, M.D.
Title
President
Phone
(530) 243-0440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X FNP 25717 CA Primary

Addresses

Primary practice location

155 Glasson Way
Grass Valley, CA 95945-5723

Mailing address

210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (714) 347-1010

Other identifiers 1

IdentifierTypeStateIssuer
GR0088230MedicaidCA

National Provider Directory

National Provider Directory

Locations

Dept LA 24446
Pasadena, CA 91185

Practitioners & affiliated clinicians

Practitioners 6

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": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388361600000",
    "number": "1285737239",
    "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": "714-347-1010",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 GLASSON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455723",
            "telephone_number": "530-274-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA NEVADA ANESTHESIA MEDICAL ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2013-12-30",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-243-0440",
        "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 25717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0088230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2013; 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.