Healthcare Provider Details

I. General information

NPI: 1235971250
Provider Name (Legal Business Name): BAUM ANESTHESIA CONSULTANTS A PROFESSIONAL NURSING ANESTHESIA CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2024
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 EGLOFF CT
FOLSOM CA
95630-6613
US

IV. Provider business mailing address

98 EGLOFF CT
FOLSOM CA
95630-6613
US

V. Phone/Fax

Practice location:
  • Phone: 713-204-8565
  • Fax:
Mailing address:
  • Phone: 713-204-8565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: TERESA S GREEN
Title or Position: RCM ADMINISTRATOR
Credential: CPC
Phone: 903-571-3844