Provider Demographics
NPI:1679526537
Name:COMMUNITY ANESTHESIA PROVIDERS MEDICAL GROUP, INC
Entity type:Organization
Organization Name:COMMUNITY ANESTHESIA PROVIDERS MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-459-6000
Mailing Address - Street 1:PO BOX 45123
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94145
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:FRESNO & R STREET
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721
Practice Address - Country:US
Practice Address - Phone:559-459-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0088281Medicaid
CA184226100OtherUS DEPT OF LABOR
CAZZZ60664ZOtherBLUE SHIELD OF CA
CAGR0088281Medicaid
CACG3930Medicare PIN