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NPI Code Detail

MEDICARE: MR. BRIAN HOWARD HASTINGS CRNA

MEDICARE: MR. BRIAN HOWARD HASTINGS CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist3310CA

General Provider Information

NPI Number : 1598742421
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN HOWARD HASTINGS CRNA
Provider Business Mailing Address
First Line : 5973 STEEPLECHASE RD
Second Line :
City : BONITA
State : CA
Zip : 91902-3041
Country : US
Telephone Number : 619-347-9282
Fax Number :
Provider Business Practice Location Address
First Line : 4647 ZION AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-2507
Country : US
Telephone Number : 619-528-5288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 07/08/2007

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