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General NPI Number Information
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NPI Number | 1356108831
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Entity Type | Organization
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Legal Business Name | VASA ANESTHESIA PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/01/2024
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 11760 CENTRAL AVE
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City | CHINO
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State | CA
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Zip | 91710-1900
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Country | US
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Telephone | 951-556-1818
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Fax |
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Provider Business Mailing Address
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Address Line | 3410 LA SIERRA AVE STE F510
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City | RIVERSIDE
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State | CA
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Zip | 92503-5270
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Country | US
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Telephone | 951-556-2138
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DIEGO ROMAN CAVENAGHI
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Credential |
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Telephone | 951-556-2138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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