Healthcare Provider Details

I. General information

NPI: 1841175767
Provider Name (Legal Business Name): DESERT CANYONS ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

754 S MAIN ST
ST GEORGE UT
84770-5504
US

IV. Provider business mailing address

PO BOX 7096
STOCKTON CA
95267-0096
US

V. Phone/Fax

Practice location:
  • Phone: 435-628-2671
  • Fax:
Mailing address:
  • Phone: 209-956-7732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY TRYON
Title or Position: SUPERVISOR
Credential:
Phone: 209-956-7732