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General NPI Number Information
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NPI Number | 1366582165
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Entity Type | Organization
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Legal Business Name | PACIFIC COAST ANESTHESIA INC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2222 LAFAYETTE ST
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City | SANTA CLARA
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State | CA
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Zip | 95050-2904
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Country | US
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Telephone | 408-354-9256
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Fax | 408-354-9257
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Provider Business Mailing Address
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Address Line | PO BOX 35695
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City | MONTE SERENO
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State | CA
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Zip | 95030-0695
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Country | US
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Telephone | 408-354-9256
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Fax | 408-354-9257
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER A VIALE
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Credential | MD
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Telephone | 408-354-9256
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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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