Healthcare Provider Details

I. General information

NPI: 1144392853
Provider Name (Legal Business Name): PAR ANESTHESIOLOGY MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 10/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 STANYAN ST
SAN FRANCISCO CA
94117-1019
US

IV. Provider business mailing address

PO BOX 101130
PASADENA CA
91189-0005
US

V. Phone/Fax

Practice location:
  • Phone: 415-668-1000
  • Fax:
Mailing address:
  • Phone: 877-693-2787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MERTON BERNARD GOODE
Title or Position: PRESIDENT
Credential: MD
Phone: 415-759-9060