Healthcare Provider Details

I. General information

NPI: 1750330627
Provider Name (Legal Business Name): VALENCIA ANESTHESIA MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 11/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23845 MCBEAN PKWY
VALENCIA CA
91355-2001
US

IV. Provider business mailing address

PO BOX 60790
PASADENA CA
91116-6790
US

V. Phone/Fax

Practice location:
  • Phone: 661-253-8000
  • Fax: 626-396-0851
Mailing address:
  • Phone: 626-795-9596
  • Fax: 626-396-0851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberG76738
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG76738
License Number StateCA

VIII. Authorized Official

Name: REUEL S ASINAS
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 626-795-6596