Organization Active NPI

Crnala, Inc

  • Certified Registered Nurse Anesthetist
  • Glendale, CA
National Provider Identifier
1760744221
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA 3307 Issued in CA
Legal business name
CRNALA, INC
Practice address
1500 S Central Ave Ste 126
Glendale, CA 91204-2571
Phone
(818) 247-4894
NPI assigned
Jun 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Authorized official

Name
Joel Diaz, CRNANPI 1447376678
Title
Ceo/President
Phone
(626) 347-3410

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X NA 3307 CA Primary

Addresses

Primary practice location

1500 S Central Ave Ste 126
Glendale, CA 91204-2571

Mailing address

609 S Grand Ave Apt 906
Los Angeles, CA 90017-3847
Phone (626) 347-3410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120724000341 CA Part B Supplier - Clinic/Group Practice 7113183948 Receives reassigned benefits from 1 practitioner
Practice locations: Studio City, CA; San Gabriel, CA; Encino, CA; Palm Desert, CA

National Provider Directory

National Provider Directory

Locations

16260 Ventura Blvd
#302
Encino, CA 91436
Phone (818) 906-7643

Practitioners & affiliated clinicians

Practitioners 1

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": "1339372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1760744221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 S GRAND AVE APT 906",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173847",
            "telephone_number": "626-347-3410",
            "fax_number": "866-640-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S CENTRAL AVE STE 126",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042571",
            "telephone_number": "818-247-4894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRNALA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "626-347-3410",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA 3307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.