Pacific Memorial Anesthesia Care, Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

1154423788 Issued in CA

Legal business name

PACIFIC MEMORIAL ANESTHESIA CARE, INC

Practice address

3300 Renner Dr
Fortuna, CA 95540-3120

Phone

(707) 725-3361

NPI assigned

Mar 21, 2007

Last updated

Aug 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

D.Peter Goldberg, M.D.

Title

President

Phone

(818) 550-0900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• D. Peter Goldberg, M.D.

  • Anesthesiology Physician
  • Fortuna, CA
  • NPI 1154423788
  Medicare reassignment NPD
• Miae Lee, CRNA

  • Anesthesiology Physician
  • Fortuna, CA
  • NPI 1154423770
  Medicare reassignment NPD

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345420800000",
    "number": "1750406146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5486",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928635486",
            "telephone_number": "818-550-0900",
            "fax_number": "505-293-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 RENNER DR",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955403120",
            "telephone_number": "707-725-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MEMORIAL ANESTHESIA CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2012-08-20",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "D.PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-550-0900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "1154423788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noreen Edwards Expressive Arts, Licensed Clinical Social Worker
• North Coast Emergency Physicians
• Philip L Olkin, M.D.
• Open Door Community Health Centers (Fortuna Community Health Center)
• Joseph A Ortola, DDS
• Paul Stauffer, P.C.
• Kristin Leigh Perkins, LCSW
• Galen Wayne Pettey, PHYSICAL THERAPIST
• Philip L. Olkin, M.D. and C. Ray Jones, M.D.
• Felice Philips

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.