Healthcare Provider Details

I. General information

NPI: 1871127522
Provider Name (Legal Business Name): SYNESTHESIA MEDICAL ASSOCIATES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2020
Last Update Date: 06/02/2020
Certification Date: 06/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S ATLANTIC BLVD
MONTEREY PARK CA
91754-4716
US

IV. Provider business mailing address

210 N TUSTIN AVE
SANTA ANA CA
92705-3807
US

V. Phone/Fax

Practice location:
  • Phone: 626-570-9000
  • Fax: 626-570-5700
Mailing address:
  • Phone: 714-347-1000
  • Fax: 714-647-1245

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: AALAP SHAH
Title or Position: PRESIDENT
Credential: MD
Phone: 714-347-1000