Healthcare Provider Details

I. General information

NPI: 1124358593
Provider Name (Legal Business Name): ANESTHESIA EXPERT CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2010
Last Update Date: 11/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 E COLORADO BLVD STE 306
PASADENA CA
91107-6648
US

IV. Provider business mailing address

2555 E COLORADO BLVD STE 306
PASADENA CA
91107-6648
US

V. Phone/Fax

Practice location:
  • Phone: 714-943-3221
  • Fax: 626-566-7620
Mailing address:
  • Phone: 714-943-3221
  • Fax: 626-566-7620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA100695
License Number StateCA

VIII. Authorized Official

Name: KEVIN L LI
Title or Position: PRESIDENT
Credential: MD
Phone: 714-943-3221