Provider Demographics
NPI:1992569743
Name:PCE CERTIFIED REGISTERED NURSING ANESTHESIOLOGY, INC.
Entity type:Organization
Organization Name:PCE CERTIFIED REGISTERED NURSING ANESTHESIOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PIA
Authorized Official - Middle Name:CARINA
Authorized Official - Last Name:ERIKSSON-ZUKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:310-947-9099
Mailing Address - Street 1:1201 N CATALINA AVE UNIT 3308
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-8268
Mailing Address - Country:US
Mailing Address - Phone:310-947-9099
Mailing Address - Fax:
Practice Address - Street 1:1201 N CATALINA AVE UNIT 3308
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-8268
Practice Address - Country:US
Practice Address - Phone:310-947-9099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty