MEDICARE: MR. VINOD C BHAN CRNA

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
1	367500000X	Certified Registered Nurse Anesthetist	RN651476	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00283966	OTHER	CA	RAILROAD MEDICARE
2	430005737	OTHER	CA	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1770554016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VINOD C BHAN CRNA

Provider Business Mailing Address
First Line	:	940 SYLVA LANE STE G
Second Line	:
City	:	SONORA
State	:	CA
Zip	:	95370-5969
Country	:	US
Telephone Number	:	209-532-0340
Fax Number	:	209-532-6405

Provider Business Practice Location Address
First Line	:	940 SYLVA LN
Second Line	:	SUITE G
City	:	SONORA
State	:	CA
Zip	:	95370-5969
Country	:	US
Telephone Number	:	209-532-0340
Fax Number	:	209-532-6405

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	06/15/2023

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Directions to “ MR. VINOD C BHAN CRNA” Practice Location

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