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Organization
LYONS HUBER ANESTHESIA A MEDICAL CORPORATION
Active
Organization
LYONS HUBER ANESTHESIA A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY CHARLES LYONS MD (GROUP PRESIDENT)
(209) 956-7732
Entity
Organization
Contact information
Practice address
10 WOODLAND RD, SAINT HELENA, CA 94574-9554
(209) 956-7732
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0104900
—
CA
01
—
ZZZ69273Z
BLUE SHIELD OF CA
CA
Enumeration date
01/25/2007
Last updated
01/29/2021
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