MEDICARE: SHARON BAKONDY 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	050169	PA

General Provider Information

NPI Number	:	1881611457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON BAKONDY CRNA

Provider Business Mailing Address
First Line	:	427 2ND ST
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-4602
Country	:	US
Telephone Number	:	310-795-1020
Fax Number	:

Provider Business Practice Location Address
First Line	:	427 2ND ST
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-4602
Country	:	US
Telephone Number	:	310-795-1020
Fax Number	:

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	09/28/2009

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Directions to “ SHARON BAKONDY CRNA” Practice Location

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