Healthcare Provider Details

I. General information

NPI: 1194473223
Provider Name (Legal Business Name): ESSENTIAL ANESTHESIA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2022
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 UPPER RAGSDALE DR STE 200
MONTEREY CA
93940-7849
US

IV. Provider business mailing address

PO BOX 7096
STOCKTON CA
95267-0096
US

V. Phone/Fax

Practice location:
  • Phone: 831-375-3577
  • Fax:
Mailing address:
  • Phone: 209-956-7732
  • Fax: 209-956-7738

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: MINH VU
Title or Position: OWNER
Credential: CRNA
Phone: 408-893-1261