Healthcare Provider Details
I. General information
NPI: 1083746259
Provider Name (Legal Business Name): RESOURCE ANESTHESIOLOGY ASSOC OF CALIFORNIA,A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2007
Last Update Date: 09/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2215 TRUXTUN AVE
BAKERSFIELD CA
93301-3602
US
IV. Provider business mailing address
450 MAMARONECK AVE STE 201
HARRISON NY
10528-2436
US
V. Phone/Fax
- Phone: 914-637-2063
- Fax:
- Phone: 914-637-2063
- Fax: 914-365-6307
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MARC
E.
KOCH
Title or Position: PRESIDENT & CEO
Credential: M.D.
Phone: 914-637-3511