Robert Daniel Nicholas Iii, CRNA | |
1781 Stoneman Dr, Suisun City, CA 94585-3218 | |
(678) 699-1559 | |
Not Available |
Full Name | Robert Daniel Nicholas Iii |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 1781 Stoneman Dr, Suisun City, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366012361 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | RN225769 (Georgia) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 95002292 (California) | Primary |
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Entity Name | Parish Anesthesia Of California A Professional Medical Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790106862 PECOS PAC ID: 0244463925 Enrollment ID: O20140503000084 |
Entity Name | Advanced Anesthesia Incorporated |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720543762 PECOS PAC ID: 4880936145 Enrollment ID: O20190507001500 |
Entity Name | Valley Regional Anesthesia Associates Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1578272415 PECOS PAC ID: 3870964323 Enrollment ID: O20230120001928 |
Entity Name | Green Anesthesia |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457039331 PECOS PAC ID: 6103270566 Enrollment ID: O20231004000338 |
Mailing Address | Practice Location Address |
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Robert Daniel Nicholas Iii, CRNA 1781 Stoneman Dr, Suisun City, CA 94585-3218 Ph: (678) 699-1559 | Robert Daniel Nicholas Iii, CRNA 1781 Stoneman Dr, Suisun City, CA 94585-3218 Ph: (678) 699-1559 |