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General NPI Number Information
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NPI Number | 1174446033
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Entity Type | Organization
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Legal Business Name | ALTERRA ANESTHESIA APMC
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 14850 ROSCOE BLVD
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4618
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Country | US
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Telephone | 818-929-8130
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Fax |
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Provider Business Mailing Address
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Address Line | 263 W OLIVE AVE STE 213
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City | BURBANK
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State | CA
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Zip | 91502-1825
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Country | US
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Telephone | 818-929-8130
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JONATHON MANSOUR
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Credential | DO
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Telephone | 818-929-8130
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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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