Healthcare Provider Details

I. General information

NPI: 1730957804
Provider Name (Legal Business Name): PACIFIC ANESTHESIA CONSULTANTS & HOSPITALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 W HORIZON RIDGE PKWY
HENDERSON NV
89052-4394
US

IV. Provider business mailing address

12 CALLE AMENO
SAN CLEMENTE CA
92672-2346
US

V. Phone/Fax

Practice location:
  • Phone: 702-805-5050
  • Fax:
Mailing address:
  • Phone: 720-984-7566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DARIN L RENTZ
Title or Position: PRESIDENT
Credential: DO
Phone: 720-984-7566