Healthcare Provider Details

I. General information

NPI: 1700741188
Provider Name (Legal Business Name): LAGNIAPPE ANESTHESIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47120 DUNE PALMS RD STE 111
LA QUINTA CA
92253-2097
US

IV. Provider business mailing address

3501 TAYLOR DR
PALM SPRINGS CA
92262-0477
US

V. Phone/Fax

Practice location:
  • Phone: 760-564-0500
  • Fax:
Mailing address:
  • Phone: 888-987-1489
  • Fax: 224-255-5813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: SHADHI AIJANI
Title or Position: OWNER
Credential:
Phone: 888-987-1489