Healthcare Provider Details

I. General information

NPI: 1265635163
Provider Name (Legal Business Name): ANESTHESIA FOR SURGERY AND OBSTETRICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 CYPRESS AVE
REEDELY CA
93654
US

IV. Provider business mailing address

PO BOX 34120
RENO NV
89533-4120
US

V. Phone/Fax

Practice location:
  • Phone: 775-747-5050
  • Fax: 775-747-5005
Mailing address:
  • Phone: 775-747-5050
  • Fax: 775-747-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN599323
License Number StateCA

VIII. Authorized Official

Name: ROD HOOVER
Title or Position: OWNER
Credential: CRNA
Phone: 559-638-8155