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General NPI Number Information
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NPI Number | 1134674468
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Entity Type | Organization
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Legal Business Name | BLESSING ANESTHESIA MEDICAL GROUP INC
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Dates
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Enumeration Date | 08/16/2016
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Last Update Date | 08/16/2016
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Provider Practice Location Address
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Address Line | 10841 WHITE OAK AVE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3817
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Country | US
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Telephone | 909-581-6400
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Fax | 909-581-6418
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Provider Business Mailing Address
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Address Line | 210 N TUSTIN AVE
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City | SANTA ANA
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State | CA
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Zip | 92705-3807
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Country | US
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Telephone | 714-347-1010
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Fax | 714-647-1245
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BLESSING AKPOFURE
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Credential | MD
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Telephone | 714-347-1010
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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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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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