Healthcare Provider Details

I. General information

NPI: 1891751939
Provider Name (Legal Business Name): DAVID HARVEY CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 W CYPRESS AVE
REEDLEY CA
93654-2113
US

IV. Provider business mailing address

200 N MADISON ST
MARSHALL MI
49068-1143
US

V. Phone/Fax

Practice location:
  • Phone: 661-633-2300
  • Fax:
Mailing address:
  • Phone: 269-781-4271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4704224360
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number965
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: