Healthcare Provider Details

I. General information

NPI: 1740809771
Provider Name (Legal Business Name): VIP ANESTHESIA SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 04/09/2020
Certification Date: 04/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 WILSHIRE BLVD
BEVERLY HILLS CA
90211-3121
US

IV. Provider business mailing address

8500 WILSHIRE BLVD
BEVERLY HILLS CA
90211-3121
US

V. Phone/Fax

Practice location:
  • Phone: 818-378-9549
  • Fax: 877-712-5707
Mailing address:
  • Phone: 818-378-9549
  • Fax: 877-712-5707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: NATALYA MELNIC
Title or Position: RCM
Credential: RCM
Phone: 818-378-9549