Healthcare Provider Details

I. General information

NPI: 1497796320
Provider Name (Legal Business Name): WESTERN ANESTHESIA MEDICAL ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27700 MEDICAL CENTER RD
MISSION VIEJO CA
92691-6426
US

IV. Provider business mailing address

PO BOX 8422
PASADENA CA
91109-8422
US

V. Phone/Fax

Practice location:
  • Phone: 949-364-1400
  • Fax:
Mailing address:
  • Phone: 503-372-2740
  • Fax: 503-372-2754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PONNAPPA KALIMADA
Title or Position: PRESIDENT
Credential: MD
Phone: 949-582-9624