Organization
AMADOR ANESTHESIA MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT HASSON MD (GROUP PRESIDENT)
(209) 223-7500
Entity
Organization
Contact information
Practice address
200 MISSION BLVD, JACKSON, CA 95642
(209) 223-7500
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
01
—
607575600
US DEPT OF LABOR
CA
01
—
DC9710
RAILROAD MEDICARE
CA
05
—
GR0099110
—
CA
01
—
ZZZ644662
BLUE SHIELD
CA
Enumeration date
05/01/2006
Last updated
06/20/2022
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