Healthcare Provider Details

I. General information

NPI: 1407596901
Provider Name (Legal Business Name): SOCAL ANESTHESIA SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 03/31/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S GRAND AVE
LOS ANGELES CA
90015-3010
US

IV. Provider business mailing address

6789 QUAIL HILL PKWY
IRVINE CA
92603-4233
US

V. Phone/Fax

Practice location:
  • Phone: 213-742-5910
  • Fax:
Mailing address:
  • Phone: 949-230-1301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DR. JAY RINDENAU
Title or Position: AUTHORIZED OFFICAL
Credential: MD
Phone: 818-902-2919