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General NPI Number Information
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NPI Number | 1205424843
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Entity Type | Organization
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Legal Business Name | KINNAIRD ANESTHESIA AND PAIN, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/08/2021
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Last Update Date | 06/15/2021
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Provider Practice Location Address
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Address Line | 4060 FOURTH AVE STE 510
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City | SAN DIEGO
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State | CA
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Zip | 92103-2121
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Country | US
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Telephone | 619-369-8115
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Fax | 619-326-3958
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Provider Business Mailing Address
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Address Line | 3555 ROSECRANS ST STE 114-531
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City | SAN DIEGO
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State | CA
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Zip | 92110-3231
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Country | US
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Telephone | 619-369-8115
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Fax | 619-215-0807
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | SHERRY CHANG KINNAIRD
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Credential |
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Telephone | 619-369-8115
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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