Healthcare Provider Details

I. General information

NPI: 1700836988
Provider Name (Legal Business Name): MORPHEUS ANESTHESIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 12/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 N CALIFORNIA ST SUITE G
STOCKTON CA
95204-5500
US

IV. Provider business mailing address

2626 N CALIFORNIA ST SUITE G
STOCKTON CA
95204-5500
US

V. Phone/Fax

Practice location:
  • Phone: 209-464-9846
  • Fax: 209-464-4082
Mailing address:
  • Phone: 209-464-9846
  • Fax: 209-464-4082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JORGE KUREK
Title or Position: PRESIDENT
Credential: M.D.
Phone: 209-464-9846