| Frederic Ransom Bushnell Iii, MD | |
|
909 South Fair Oaks Avenue, Pasadena, CA 91105-2625 | |
| (626) 389-9300 | |
| (626) 389-9336 |
| Full Name | Frederic Ransom Bushnell Iii |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Location | 909 South Fair Oaks Avenue, Pasadena, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003830092 | NPI | - | NPPES |
| 00A743490 | Other | CA | BLUE SHIELD |
| 00A743490 | Medicaid | CA | |
| 00A743491 | Other | CA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | A74349 (California) | Primary |
| Entity Name | Pacific Valley Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851312862 PECOS PAC ID: 3577465368 Enrollment ID: O20040122000762 |
| Entity Name | Shriners Hospitals For Children |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871043224 PECOS PAC ID: 9133031933 Enrollment ID: O20131115001486 |
| Mailing Address | Practice Location Address |
|---|---|
| Frederic Ransom Bushnell Iii, MD Shriners Hospitals For Children, Po Box 8500, Philadelphia, PA 19178-8113 Ph: (813) 281-8478 | Frederic Ransom Bushnell Iii, MD 909 South Fair Oaks Avenue, Pasadena, CA 91105-2625 Ph: (626) 389-9300 |
Austin Wu, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 100 W California Blvd, Pasadena, CA 91105 Phone: 310-267-8654 | |
Thomas John Carpenter Jr., M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 100 W California Blvd, Pasadena, CA 91105 Phone: 626-397-5000 Fax: 626-397-2912 | |
Luke Hyaryul Chang, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 100 W California Blvd, Pasadena, CA 91105 Phone: 626-397-5000 Fax: 626-397-2912 | |
Hayk Minasyan, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2923 Bradley St Ste 120, Pasadena, CA 91107 Phone: 626-639-6214 | |
Kevin K Li, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2555 E Colorado Blvd Ste 306, Pasadena, CA 91107 Phone: 626-538-8950 Fax: 626-566-7620 | |
Ernest Keith Polk, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 100 W California Blvd, Pasadena, CA 91105 Phone: 626-397-5000 Fax: 626-397-2912 |