Blue Eagle Anesthesia Inc a Professional Corporation
Organization Active NPI Anesthesiology Physician · Daly City, CA
NPI 1396822326 · NPPES record last updated Mar 14, 2012
Key facts
- NPI
- 1396822326
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- BLUE EAGLE ANESTHESIA INC A PROFESSIONAL CORPORATION
- Practice address
- 901 Campus Dr
Suite 102
Daly City, CA 94015-4900 - Phone
- (650) 991-2000
- Fax
- (650) 755-8638
- NPI assigned
- Nov 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Yi Ching Chiang, DO
- Title
- Group President
- Phone
- (650) 991-2000
Practitioners 53
-
Yi Ching Chiang, DO
-
Willy Ching, CRNA
-
Johanne Daniel, CRNA
-
Jon Harlow Flores, DNP, CRNA
-
John Hessler, DNP, CRNA
-
Kantilal V Kanzaria, M.D.
-
Ryan Lee, CRNA
-
Chester Rex Lusaria, CRNA
-
Yoko Mori, CRNA
-
Whitney Marie Nagy, CRNA
-
Sadia Peck, CRNA
-
Jessica Jones Servin, CRNA
-
Marie Simonetti, CRNA
-
Curtis William Yee, CRNA
-
Caroline Young Yi, CRNA
-
Mary Grace Q Bagalso, CRNA
-
Nason Eric Landreneau, CRNA
-
Theodore Alan Wong, CRNA, RN
-
Wendy Kuang, CRNA
-
Mark Min-Young Ahn, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090604000185 | CA | Part B Supplier - Clinic/Group Practice | 3577613017 |
Receives reassigned benefits from 53 practitioners Practice locations: Daly City, CA; San Francisco, CA |
National Provider Directory
Locations
901 Campus Dr
Ste 201
Daly City, CA 94015
Phone (503) 724-7065
1160 Post St
San Francisco, CA 94109
Phone (415) 440-1100
1160 Post St
Ste 102
San Francisco, CA 94109
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes | ||
| Pain Medicine (Anesthesiology) Physician |
207LP2900X | |||
| Pain Medicine Physician |
208VP0000X |
Addresses
Primary practice location
901 Campus Dr
Suite 102
Daly City, CA 94015-4900
Mailing address
PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725
Other providers in Daly City, CA
- Arter Biggs
- Audrey Binsfeld
- Maria J. Blanco
- Kevin Blodgett
- Jennifer Bloomer
- Pamela M Blum
- Cedric Bobro
- Christian Reyes Bocobo
- Lesley Alexxandra Bode
- Tomasz Bodzianowski
All providers in Daly City, CA · Anesthesiology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.