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MAD RIVER COMMUNITY ANESTHESIA MEDICAL GROUP NPI 1578599619


NPI Information

NPI: 1578599619
Provider Name: MAD RIVER COMMUNITY ANESTHESIA MEDICAL GROUP
Classification: Anesthesiology - 207LP2900X
Entity Type: Organization

Specialization: Pain Medicine

CLIA Number: 05D0612926

Address:
3800 JANES RD
ARCATA, CA
ZIP 95521
Phone: (707) 822-7250
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MAD RIVER COMMUNITY ANESTHESIA MEDICAL GROUP is a pain medicine anesthesiology in Arcata, CA. The provider is an anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. MAD RIVER COMMUNITY ANESTHESIA MEDICAL GROUP NPI is 1578599619. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3800 JANES RD
ARCATA, CA
ZIP 95521-742
Phone: (707) 822-7250
Fax: (707) 826-8258

The provider's authorized official is Michael J Young .
The authorized official title is C.f.o. and has the following contact phone number (707) 826-8203.

The CLIA number assigned to this NPI record is 05D0612926 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 6/23/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207LP2900XAnesthesiologyPain MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PENDINGMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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