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General NPI Number Information
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NPI Number | 1336537174
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Entity Type | Individual
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Provider Name | CAMERON THOMAS LOVINGER CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/01/2015
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Last Update Date | 01/01/2015
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Provider Practice Location Address
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Address Line | 444 BRUCE ST
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City | YREKA
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State | CA
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Zip | 96097-3450
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Country | US
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Telephone | 530-842-4121
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Fax | 530-841-0913
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Provider Business Mailing Address
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Address Line | 182 STACY CT
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City | YREKA
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State | CA
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Zip | 96097-2742
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Country | US
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Telephone | 216-224-5950
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 105665
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License Number State | CA
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