Healthcare Provider Details

I. General information

NPI: 1265960215
Provider Name (Legal Business Name): ANESTHESIOLOGY SPECIALISTS OF CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2017
Last Update Date: 06/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31700 TEMECULA PKWY
TEMECULA CA
92592-5896
US

IV. Provider business mailing address

PO BOX 34120
RENO NV
89533-4120
US

V. Phone/Fax

Practice location:
  • Phone: 951-331-2209
  • Fax:
Mailing address:
  • Phone: 858-495-0971
  • Fax: 858-495-0991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA129884
License Number StateCA

VIII. Authorized Official

Name: DR. BRIAN J TELESZ
Title or Position: PRESIDENT
Credential: MD
Phone: 858-495-0971