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General NPI Number Information
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NPI Number | 1104923358
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Entity Type | Organization
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Legal Business Name | SURGICAL ANESTHESIA MEDICAL ASSOCIATES INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 18575 GALE AVE STE 198
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91748-1382
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Country | US
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Telephone | 626-965-3880
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4259
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City | CERRITOS
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State | CA
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Zip | 90703-4259
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Country | US
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Telephone | 562-407-2080
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HENRY CHANG
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Credential | MD
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Telephone | 562-407-2080
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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 |
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License Number State |
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