Healthcare Provider Details

I. General information

NPI: 1821427196
Provider Name (Legal Business Name): NEW LINE ANESTHESIA SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W 7TH ST
SAN PEDRO CA
90732-3505
US

IV. Provider business mailing address

P O BOX 80182
CITY OF INDUSTRY CA
91716-8178
US

V. Phone/Fax

Practice location:
  • Phone: 310-832-3311
  • Fax:
Mailing address:
  • Phone: 310-698-5477
  • Fax: 310-379-4856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA66108
License Number StateCA

VIII. Authorized Official

Name: IRV EDWARD EDWARDS
Title or Position: CEO
Credential:
Phone: 310-379-2134