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NPI Code Detail

MEDICARE: ANESTHESIOLOGY CONSULTANTS MEDICAL GROUP, INC.

MEDICARE: ANESTHESIOLOGY CONSULTANTS 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

General Provider Information

NPI Number : 1972534048
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANESTHESIOLOGY CONSULTANTS MEDICAL GROUP, INC.
Provider Business Mailing Address
First Line : PO BOX 7156
Second Line :
City : STOCKTON
State : CA
Zip : 95267-0156
Country : US
Telephone Number : 209-467-6866
Fax Number : 209-467-6865
Provider Business Practice Location Address
First Line : 525 W ACACIA ST
Second Line :
City : STOCKTON
State : CA
Zip : 95203-2405
Country : US
Telephone Number : 209-944-5550
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : PHILLIP N RUHL
Credential : DO
Telephone Number : 209-944-5550
Provider Enumeration Date : 07/06/2006
Last Update Date : 08/22/2020

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