NPIMap

Organization Active NPI

Medicgas, Inc.

  • Anesthesiology Physician
  • Indio, CA
National Provider Identifier
1689801631
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A81737 Issued in CA
Legal business name
MEDICGAS, INC.
Practice address
81812 Dr Carreon Blvd
F
Indio, CA 92201-5594
Phone
(760) 775-2225
Fax
(760) 775-2377
NPI assigned
Jun 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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

Authorized official

Name
Dr. Peer O Theobald, M.D.
Title
President
Phone
(760) 989-0507

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X A81737 CA Primary

Addresses

Primary practice location

81812 Dr Carreon Blvd
F
Indio, CA 92201-5594

Mailing address

225 S Lake Ave
535
Pasadena, CA 91101-3005
Phone (626) 204-6747

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1689801631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S LAKE AVE",
            "address_2": "535",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911013005",
            "telephone_number": "626-204-6747",
            "fax_number": "626-396-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81812 DR CARREON BLVD",
            "address_2": "F",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015594",
            "telephone_number": "760-775-2225",
            "fax_number": "760-775-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICGAS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-17",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "THEOBALD",
        "authorized_official_first_name": "PEER",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-989-0507",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A81737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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.