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General NPI Number Information
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NPI Number | 1164722153
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Entity Type | Organization
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Legal Business Name | TORREY PINES ANESTHESIA CONSULTANTS
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Dates
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Enumeration Date | 10/25/2010
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Last Update Date | 10/25/2010
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Provider Practice Location Address
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Address Line | 9850 GENESEE AVE STE 610
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City | LA JOLLA
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State | CA
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Zip | 92037-1217
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Country | US
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Telephone | 858-558-2294
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Fax | 858-558-2260
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Provider Business Mailing Address
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Address Line | PO BOX 910426
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City | SAN DIEGO
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State | CA
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Zip | 92191-0426
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Country | US
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Telephone | 619-271-9923
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Fax | 619-407-7498
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Authorized Official
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Title or Position | ANESTHESIOLOGISTS
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Name | MR. EDWARD PEREZ LIZANO
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Credential | M.D.
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Telephone | 619-271-9923
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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 | A52868
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License Number State | CA
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