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General NPI Number Information
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NPI Number | 1467820175
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Entity Type | Organization
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Legal Business Name | ANESTHESIA MEDICAL GROUP GRIGORE PLLC
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 1800 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102-2329
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Country | US
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Telephone | 713-203-2475
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 SPRING GATE LN P.O.BOX 371658
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City | LAS VEGAS
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State | NV
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Zip | 89137-8801
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. ALINA GRIGORE
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Credential | M.D.
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Telephone | 713-203-2475
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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 | 14884
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License Number State | NV
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