Organization
FOOTHILL ANESTHESIA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY SCOTT WRIGHT CRNA (PRESIDENT)
(818) 317-6909
Entity
Organization
Contact information
Practice address
301 S FAIR OAKS AVE STE 301, PASADENA, CA 91105-2562
(818) 317-6909
Mailing address
301 S FAIR OAKS AVE STE 301, PASADENA, CA 91105-2562
(818) 317-6909
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN375160, NA1954
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN3751600
—
CA
01
—
ZZZ64046Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
03/28/2006
Last updated
08/05/2021
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