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LEE AUSTIN CRNA

>> Registered Nurse >> Nursing Service Providers

Registrant NPI Number: 1467511881

Individual Registrant:
 LEE  AUSTIN CRNA
Gender: M
Not Sole Proprietor

Location and contact information for practice:
650 SANITARIUM RD  DEER PARK, CA 94576 US
Tel: 707-963-3611  Fax: 707-967-5622

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

Registration Information:
NPI: 1467511881
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N163W00000XNursing Service Providers
Registered Nurse
CARN592567
Y367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
CANA2796

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
RN5925670CA05
US DEPT OF LABOR359252000CA01
BLUE SHIELD OF CANA0027960CA01




HEALTH CARE JOBS CA - Page 1



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