MEDICARE: RADIUS ANESTHESIA OF CALIFORNIA, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1770933145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIUS ANESTHESIA OF CALIFORNIA, PC

Provider Business Mailing Address
First Line	:	6464 W SUNSET BLVD
Second Line	:	SUITE 790
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-8001
Country	:	US
Telephone Number	:	323-417-0335
Fax Number	:

Provider Business Practice Location Address
First Line	:	6464 W SUNSET BLVD
Second Line	:	SUITE 790
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-8001
Country	:	US
Telephone Number	:	323-417-0335
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HAROON W CHAUDHRY
Credential	:	MD
Telephone Number	:	917-621-6854

Provider Enumeration Date	:	06/16/2016
Last Update Date	:	06/16/2016

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