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DAVID P CARELOCK CRNA

>> Nurse Anesthetist, Certified Registered >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1790773596

Individual Registrant:
 DAVID P CARELOCK CRNA
Gender: M
Not Sole Proprietor

Location and contact information for practice:
10 WOODLAND RD  SAINT HELENA, CA 94574-9554 US
Tel: 707-963-3611  Fax: 254-200-4090

Contact information for business:
PO BOX 7096  STOCKTON, CA 95267-0096 US
Tel: 209-956-7725  Fax: 209-956-7733

Registration Information:
NPI: 1790773596
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
TX637274
Y367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
CANA3375

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
FIRSTCARE109873101TX01
006844701TX05
BLUE CROSS BLUE SHIELD00C073MTX01




HEALTH CARE JOBS CA - Page 1



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