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1083928501 NPI number — PALM SPRINGS ANESTHESIA SERVICES, PC

NPI Number: 1083928501
Health Care Provider/Practitioner: PALM SPRINGS ANESTHESIA SERVICES, PC

Information about “1083928501” NPI (PALM SPRINGS ANESTHESIA SERVICES, PC) exists in 1083928501 in HTML format HTML  |  1083928501 in plain Text format TXT  |  1083928501 in PDF (Portable Document Format) PDF  |  1083928501 in an XML format XML  formats.

NPI Number : 1083928501 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1083928501",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PALM SPRINGS ANESTHESIA SERVICES, PC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "450 MAMARONECK AVE STE 201",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HARRISON",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10528-2436",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "914-637-3530",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2101 N WATERMAN AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN BERNARDINO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92404-4836",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "877-580-3144",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/27/2010",
    "LastUpdateDate": "06/18/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KOCH",
    "AuthorizedOfficialFirstName": "MARC",
    "AuthorizedOfficialMiddleName": "E.",
    "AuthorizedOfficialTitle": "PRESIDENT/CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "877-476-6642",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207L00000X",
        "TaxonomyName": "Anesthesiology Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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