=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366531410
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET CLARSON CRNA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/12/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2485 HIGH SCHOOL AVE SUITE 227
-----------------------------------------------------
City | CONCORD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94520-1819
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-682-2131
-----------------------------------------------------
Fax | 925-676-7411
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1834 STONE AVE SUITE 2B
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95125-1306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-995-0102
-----------------------------------------------------
Fax | 408-995-0190
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number | RN230387
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------