Healthcare Provider Details
I. General information
NPI: 1669419024
Provider Name (Legal Business Name): WHITTIER ANESTHESIA ASSOCIATES A PROFESSIONAL MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/02/2006
Last Update Date: 02/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12401 WASHINGTON BLVD
WHITTIER CA
90602-1006
US
IV. Provider business mailing address
PO BOX 3098
TORRANCE CA
90510-3098
US
V. Phone/Fax
- Phone: 562-698-0811
- Fax: 562-696-3193
- Phone: 310-792-3914
- Fax: 855-898-4055
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
SYED
I
ALI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 562-943-0662