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NPI Code Detail

MEDICARE: FULLERTON ANESTHESIA ASSOCIATES, A MEDICAL GROUP, INC.

MEDICARE: FULLERTON ANESTHESIA ASSOCIATES, A MEDICAL GROUP, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144278433
Entity Type Code : Organization
Provider Name (Legal Business Name) : FULLERTON ANESTHESIA ASSOCIATES, A MEDICAL GROUP, INC.
Provider Business Mailing Address
First Line : PO BOX 8258
Second Line :
City : PASADENA
State : CA
Zip : 91109-8258
Country : US
Telephone Number : 503-372-2740
Fax Number : 503-372-2754
Provider Business Practice Location Address
First Line : 101 E VALENCIA MESA DR
Second Line :
City : FULLERTON
State : CA
Zip : 92835-3809
Country : US
Telephone Number : 714-871-3280
Fax Number : 714-447-6490
Authorized Official
Title or Position : GROUP PRESIDENT
Name : JOHN BYRON MACCARTHY
Credential : MD
Telephone Number : 503-372-2740
Provider Enumeration Date : 05/05/2006
Last Update Date : 05/14/2009

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