Healthcare Provider Details

I. General information

NPI: 1801448105
Provider Name (Legal Business Name): VIGILANT ANESTHESIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 S ROBERTSON BLVD STE 100B
LOS ANGELES CA
90035-1613
US

IV. Provider business mailing address

325 N MAPLE DR UNIT 1543
BEVERLY HILLS CA
90213-4998
US

V. Phone/Fax

Practice location:
  • Phone: 818-457-1647
  • Fax:
Mailing address:
  • Phone: 818-457-1647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JOSEPH ENAYATI
Title or Position: PRESIDENT/MEDICAL DIRECTOR
Credential: DO
Phone: 310-651-6937