Healthcare Provider Details

I. General information

NPI: 1619343423
Provider Name (Legal Business Name): DEMOCRATIC ANESTHESIOLOGISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2015
Last Update Date: 12/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S RAYMOND AVE
PASADENA CA
91105-3229
US

IV. Provider business mailing address

PO BOX 90730
PASADENA CA
91109-0730
US

V. Phone/Fax

Practice location:
  • Phone: 626-795-8051
  • Fax: 626-795-7374
Mailing address:
  • Phone: 626-795-8051
  • Fax: 626-795-7374

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. MICHAEL J FRAIPONT
Title or Position: MANAGING PHYSICIAN
Credential: MD
Phone: 626-795-8051