Provider Demographics
NPI: | 1679847727 |
---|---|
Name: | AMSURG OAKLAND ANESTHESIA LP |
Entity type: | Organization |
Organization Name: | AMSURG OAKLAND ANESTHESIA LP |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SR DIRECTOR OF RCM TRANSFORMATION |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JEAN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KOCHENDORFER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 615-240-3795 |
Mailing Address - Street 1: | 1A BURTON HILLS BLVD |
Mailing Address - Street 2: | ATTN: PROVIDER ENROLLMENT |
Mailing Address - City: | NASHVILLE |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 37215-6187 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 615-240-3809 |
Mailing Address - Fax: | 615-234-1809 |
Practice Address - Street 1: | 300 FRANK OGAWA PLAZA |
Practice Address - Street 2: | SUITE 135 |
Practice Address - City: | OAKLAND |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94612-2070 |
Practice Address - Country: | US |
Practice Address - Phone: | 510-893-1600 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-03-06 |
Last Update Date: | 2023-01-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Single Specialty |