Healthcare Provider Details

I. General information

NPI: 1811347602
Provider Name (Legal Business Name): AN ANESTHESIA AND PAIN MANAGEMENT MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2016
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 MONTEGO STE 104
WALNUT CREEK CA
94598-2960
US

IV. Provider business mailing address

PO BOX 5668
WALNUT CREEK CA
94596-1668
US

V. Phone/Fax

Practice location:
  • Phone: 707-748-7248
  • Fax: 707-745-9076
Mailing address:
  • Phone: 707-748-7248
  • Fax: 707-745-9076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA44609
License Number StateCA

VIII. Authorized Official

Name: ARUN ANAND
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.D.
Phone: 925-787-3697