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Organization
NODAK ANESTHESIA, INC
Active
Organization
NODAK ANESTHESIA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J. WYNN ALLEN CRNA (PRESIDENT)
(559) 816-5062
Entity
Organization
Contact information
Practice address
1025 N DOUTY ST, CENTRAL VALLEY GEN. HOSPITAL, HANFORD, CA 93230-3722
(559) 587-4344
Mailing address
PO BOX 264, LEMOORE, CA 93245-0264
(559) 813-5062
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
GRN000140
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GRN000140
—
CA
Enumeration date
08/16/2007
Last updated
08/16/2007
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