Healthcare Provider Details

I. General information

NPI: 1174792261
Provider Name (Legal Business Name): EMPIRE ANESTHESIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 06/30/2024
Certification Date: 06/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 NORRIS CANYON RD STE 100
SAN RAMON CA
94583-5410
US

IV. Provider business mailing address

PO BOX 25033
SANTA ANA CA
92799-5033
US

V. Phone/Fax

Practice location:
  • Phone: 925-973-0605
  • Fax: 925-973-0653
Mailing address:
  • Phone: 714-347-1010
  • Fax: 714-347-1082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberFNP 37065
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberFNP 37065
License Number StateCA

VIII. Authorized Official

Name: DR. ROBIN M DENNINGS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-347-1010