Healthcare Provider Details

I. General information

NPI: 1194778621
Provider Name (Legal Business Name): COMMUNITY ANESTHESIA PROVIDERS MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2755 HERNDON
CLOVIS CA
93612
US

IV. Provider business mailing address

PO BOX 45123
SAN FRANCISCO CA
94145
US

V. Phone/Fax

Practice location:
  • Phone: 559-324-4000
  • Fax:
Mailing address:
  • Phone: 209-956-7725
  • Fax: 209-956-7733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLOS HUANES
Title or Position: GROUP PRESIDENT
Credential: MD
Phone: 559-324-4000