Healthcare Provider Details

I. General information

NPI: 1013540863
Provider Name (Legal Business Name): AVANT ANESTHESIA ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 WILSHIRE BLVD STE 100
BEVERLY HILLS CA
90210-6100
US

IV. Provider business mailing address

PO BOX 1325
BEVERLY HILLS CA
90213-1325
US

V. Phone/Fax

Practice location:
  • Phone: 310-855-3960
  • Fax: 310-382-2422
Mailing address:
  • Phone: 310-855-3960
  • Fax: 310-382-2422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: PERRY LIU
Title or Position: PRESIDENT
Credential: MD
Phone: 310-855-3960