Provider Demographics
NPI:1043483456
Name:GENERAL ANESTHESIA SERVICES A PROFESSIONAL NURSING CORP
Entity type:Organization
Organization Name:GENERAL ANESTHESIA SERVICES A PROFESSIONAL NURSING CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:QUIER
Authorized Official - Suffix:JR
Authorized Official - Credentials:CRNA
Authorized Official - Phone:760-793-1121
Mailing Address - Street 1:648 N SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-3314
Mailing Address - Country:US
Mailing Address - Phone:760-793-1121
Mailing Address - Fax:760-793-1121
Practice Address - Street 1:648 N SCOTT ST
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-3314
Practice Address - Country:US
Practice Address - Phone:760-793-1121
Practice Address - Fax:760-793-1121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-07
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADL314AMedicare PIN