MEDICARE: MR. EUGENE ELLIS 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
1	367500000X	Certified Registered Nurse Anesthetist	3473	CA
2	367500000X	Certified Registered Nurse Anesthetist	NA3473	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	NA0034730	OTHER	CA	BLUE SHIELD OF CA

General Provider Information

NPI Number	:	1740311513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EUGENE ELLIS CRNA

Provider Business Mailing Address
First Line	:	1385 HOLLOWAY AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-2664
Country	:	US
Telephone Number	:	415-867-0177
Fax Number	:	415-867-0177

Provider Business Practice Location Address
First Line	:	5801 NORTH CANYON RD
Second Line	:	SUITE 230
City	:	SAN RAMON
State	:	CA
Zip	:	94583-5440
Country	:	US
Telephone Number	:	925-275-9910
Fax Number	:	925-275-9823

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	11/29/2021

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1063417814 — DR. SANFORD LEWIS SEVERIN M.D.
Practice Location Address:

5801 NORRIS CANYON RD , STE 200
SAN RAMON, CA
94583-5440

Practice Phone: 925-830-8823
Practice Fax: 925-866-6610

1972570752 — DR. JOHN K. FRAZIER MD
Practice Location Address:

5801 NORRIS CANYON RD , SUITE 210
SAN RAMON, CA
94583-5440

Practice Phone: 925-355-7350
Practice Fax:

1295702553 — NORMAN YAMADA PA
Practice Location Address:

5801 NORRIS CANYON RD , SUITE 210
SAN RAMON, CA
94583-5440

Practice Phone: 925-355-7350
Practice Fax:

1093783763 — WEBSTER ORTHOPAEDIC MEDICAL GROUP, A PROFESSIONAL CORPORATION
Practice Location Address:

5801 NORRIS CANYON RD , SUITE 210
SAN RAMON, CA
94583-5440

Practice Phone: 925-355-7350
Practice Fax:

1174549729 — KATHLEEN ANN GEIER NP, RN, CNS
Practice Location Address:

5801 NORRIS CANYON RD , SUITE 210
SAN RAMON, CA
94583-5440

Practice Phone: 925-355-7350
Practice Fax: 925-244-1457

1386654200 — DAVID T WONG M.D.
Practice Location Address:

5801 NORRIS CANYON RD , SUITE 230
SAN RAMON, CA
94583-5440

Practice Phone: 925-275-9966
Practice Fax:

Directions to “ MR. EUGENE ELLIS CRNA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.