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General NPI Number Information
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NPI Number | 1760693469
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Entity Type | Organization
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Legal Business Name | NORTHSTATE ANESTHESIOLOGY PARTNERS A MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 03/15/2012
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Provider Practice Location Address
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Address Line | 888 LAKESIDE VLG COMMONS
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City | CHICO
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State | CA
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Zip | 95928-3979
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Country | US
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Telephone | 530-332-6800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7096
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City | STOCKTON
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State | CA
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Zip | 95267-0096
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Country | US
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Telephone | 209-956-7725
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Fax | 209-956-7733
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Authorized Official
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Title or Position | GROUP PRESIDENT
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Name | MICHAEL PRYOMSKI
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Credential | DO
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Telephone | 530-332-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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