Healthcare Provider Details

I. General information

NPI: 1225977366
Provider Name (Legal Business Name): PRESIDIO ANESTHESIA GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 DE LA VINA ST
SANTA BARBARA CA
93105-3351
US

IV. Provider business mailing address

2550 E ROSE GARDEN LN UNIT 72210
PHOENIX AZ
85050-7749
US

V. Phone/Fax

Practice location:
  • Phone: 805-569-3226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MEGHAN GIBSON
Title or Position: MANAGER
Credential:
Phone: 602-301-9259