Individual
JAMES R SUNDET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
726 4TH ST, MARYSVILLE, CA 95901-5656
(530) 749-4300
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0144
SD
367500000X
Certified Registered Nurse Anesthetist
D103511
IA
367500000X
Certified Registered Nurse Anesthetist
Primary
NA2840
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145405
BCBS KS GROUP 110017
KS
05
—
200420950A
—
KS
05
—
5752583
—
SD
Enumeration date
02/15/2006
Last updated
06/01/2016
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