Healthcare Provider Details

I. General information

NPI: 1528352242
Provider Name (Legal Business Name): ECSV ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2011
Last Update Date: 05/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 COMMERCE STREET SUITE 740
NASHVILLE TN
37219-2479
US

IV. Provider business mailing address

2410 SAMARITAN DR SUITE 100
SAN JOSE CA
95124-3909
US

V. Phone/Fax

Practice location:
  • Phone: 615-345-6900
  • Fax:
Mailing address:
  • Phone: 408-369-9798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID W HOLST
Title or Position: EVP-COO
Credential:
Phone: 615-345-6899