Healthcare Provider Details

I. General information

NPI: 1033697305
Provider Name (Legal Business Name): HEYER ANESTHESIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 09/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 W LA VETA AVE STE 330
ORANGE CA
92868-4231
US

IV. Provider business mailing address

PO BOX 5486
ORANGE CA
92863-5486
US

V. Phone/Fax

Practice location:
  • Phone: 714-332-5502
  • Fax:
Mailing address:
  • Phone: 818-550-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberG65232
License Number StateCA

VIII. Authorized Official

Name: ERIC HEYER
Title or Position: PRESIDENT
Credential: MD
Phone: 303-579-8943