Healthcare Provider Details

I. General information

NPI: 1134039167
Provider Name (Legal Business Name): ULTIMATE ANESTHESIA ADVANCED PRACTICE NURSING CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28975 OLD TOWN FRONT ST STE 100
TEMECULA CA
92590-2863
US

IV. Provider business mailing address

42513 LYLES DR
TEMECULA CA
92592-4414
US

V. Phone/Fax

Practice location:
  • Phone: 630-809-9717
  • Fax:
Mailing address:
  • Phone: 630-809-9717
  • Fax:

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: SCOTT STERBA
Title or Position: PRESIDENT
Credential: CRNA
Phone: 630-809-9717