Healthcare Provider Details

I. General information

NPI: 1548218944
Provider Name (Legal Business Name): GROUP ANESTHESIA SERVICES INC., A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 12/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 SAMARITAN DR
SAN JOSE CA
95124-3908
US

IV. Provider business mailing address

PO BOX 51441
LOS ANGELES CA
90051-5741
US

V. Phone/Fax

Practice location:
  • Phone: 408-558-2100
  • Fax: 408-559-2609
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberN/A
License Number State

VIII. Authorized Official

Name: DR. HENRY KAMALI
Title or Position: PRESIDENT
Credential: MD
Phone: 503-372-2740