Organization
VINOD C BHAN
Active
Other names
MID VALLEY ANESTHESIA
Organization subpart
No
Provider details
NPI number
Authorized official
VINNIE C BHAN CRNA (OWNER)
(209) 956-7725
Entity
Organization
Contact information
Practice address
1805 N CALIFORNIA ST, SUITE 101, STOCKTON, CA 95204-6037
(209) 956-7725
(209) 948-9321
Mailing address
1144 NORMAN DR, SUITE 102, MANTECA, CA 95336-5925
(209) 956-7725
(209) 823-3376
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
NA41
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ03666Z
GROUP PTAN
CA
Enumeration date
10/23/2006
Last updated
02/12/2021
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