Healthcare Provider Details

I. General information

NPI: 1629781695
Provider Name (Legal Business Name): PLATINUM ANESTHESIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2023
Last Update Date: 01/04/2023
Certification Date: 01/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9041 MAGNOLIA AVE SUITE 003
RIVERSIDE CA
92503
US

IV. Provider business mailing address

703 PIER AVE SUITE B #602
HERMOSA BEACH CA
90254
US

V. Phone/Fax

Practice location:
  • Phone: 562-472-3266
  • Fax:
Mailing address:
  • Phone: 562-472-3266
  • Fax:

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. LUKE KAMEL
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 562-472-3266