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General NPI Number Information
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NPI Number | 1023253804
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Entity Type | Organization
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Legal Business Name | METRO ANESTHESIA GROUP
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 12/09/2008
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Provider Practice Location Address
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Address Line | 22990 WREN ST
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City | GRAND TERRACE
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State | CA
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Zip | 92313-5582
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Country | US
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Telephone | 310-963-2508
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Fax |
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Provider Business Mailing Address
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Address Line | 22990 WREN ST
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City | GRAND TERRACE
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State | CA
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Zip | 92313-5582
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Country | US
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Telephone | 310-963-2508
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Fax |
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Authorized Official
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Title or Position | ANESTHESIA
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Name | MR. MONTE M CHRISTEN
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Credential | CRNA
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Telephone | 310-963-2508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | NA2689
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License Number State | CA
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