=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376596650
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AN ANESTHESIA AND PAIN MANAGEMENT MEDICAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2006
-----------------------------------------------------
Last Update Date | 12/03/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1208 E 5TH ST SUITE 300
-----------------------------------------------------
City | BENICIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94510-3502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-748-7248
-----------------------------------------------------
Fax | 707-745-9076
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 5668
-----------------------------------------------------
City | WALNUT CREEK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94596-1668
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-745-3112
-----------------------------------------------------
Fax | 707-745-9076
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. ARUN ANAND
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 707-745-3112
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207LP2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------