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General NPI Number Information
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NPI Number | 1275863599
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Entity Type | Organization
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Legal Business Name | GOLDEN STATE ANESTHESIA CONSULTANTS, INC.
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Dates
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Enumeration Date | 01/08/2010
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 278 E COLORADO BLVD 1514
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City | PASADENA
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State | CA
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Zip | 91101-2253
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Country | US
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Telephone | 626-676-0028
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Fax |
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Provider Business Mailing Address
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Address Line | 5565 CENTERVIEW DR STE 107
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City | RALEIGH
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State | NC
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Zip | 27606-3563
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Country | US
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Telephone | 844-248-4320
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | KATHLEEN KONDAS
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Credential |
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Telephone | 954-838-2371
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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 | G53323
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License Number State | CA
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