Healthcare Provider Details

I. General information

NPI: 1730667841
Provider Name (Legal Business Name): ALLIANCE ANESTHESIA ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 STUDEBAKER RD
NORWALK CA
90650-2531
US

IV. Provider business mailing address

PO BOX 25033
SANTA ANA CA
92799-5033
US

V. Phone/Fax

Practice location:
  • Phone: 562-868-3751
  • Fax: 562-929-3582
Mailing address:
  • Phone: 714-347-1000
  • Fax: 714-795-6829

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. FERNANDO GAVIA
Title or Position: PRESIDENT
Credential: MD
Phone: 714-347-1010