| Kevin Ross Gustafson, CRBA | |
|
6358 Sombrero Ave, Cypress, CA 90630-5326 | |
| (562) 225-0025 | |
| Not Available |
| Full Name | Kevin Ross Gustafson |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 11 Years |
| Location | 6358 Sombrero Ave, Cypress, California |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710360938 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 95000397 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Raelle Anesthesia Inc | 8123260874 | 11 |
| Entity Name | Regents of the University of |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487602546 PECOS PAC ID: 8729983473 Enrollment ID: O20031204001085 |
| Entity Name | MD Solutions Medical Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902837735 PECOS PAC ID: 1759379993 Enrollment ID: O20040505000671 |
| Entity Name | Advanced Anesthesia Specialists a Medical Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871733600 PECOS PAC ID: 0042340705 Enrollment ID: O20100608000088 |
| Entity Name | Knd Development 59 LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740519081 PECOS PAC ID: 3678602802 Enrollment ID: O20100724000249 |
| Entity Name | Raelle Anesthesia Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437499266 PECOS PAC ID: 8123260874 Enrollment ID: O20130809000303 |
| Entity Name | Tower Anesthesia Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407370901 PECOS PAC ID: 3375815723 Enrollment ID: O20170818001842 |
| Entity Name | Brand Surgery Center LLC |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1437537107 PECOS PAC ID: 7810205226 Enrollment ID: O20180612003371 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Ross Gustafson, CRBA 6358 Sombrero Ave, Cypress, CA 90630-5326 Ph: (562) 225-0025 | Kevin Ross Gustafson, CRBA 6358 Sombrero Ave, Cypress, CA 90630-5326 Ph: (562) 225-0025 |