Healthcare Provider Details

I. General information

NPI: 1457399933
Provider Name (Legal Business Name): CALIFORNIA ANESTHESIA ASSOCIATES MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 11/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 ATLANTIC AVE
LONG BEACH CA
90806-1737
US

IV. Provider business mailing address

PO BOX 10429
NEWPORT BEACH CA
92658-0429
US

V. Phone/Fax

Practice location:
  • Phone: 562-933-2000
  • Fax: 562-933-1336
Mailing address:
  • Phone: 714-415-4050
  • Fax: 714-415-4053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT KEVIN JONES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 949-417-1812