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General NPI Number Information
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NPI Number | 1568976447
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Entity Type | Organization
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Legal Business Name | PERIOPERATIVE ANESTHESIA CONSULTANTS
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 371 VAN NESS WAY STE 210
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City | TORRANCE
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State | CA
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Zip | 90501-6297
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Country | US
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Telephone | 310-792-3914
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Fax | 855-898-4055
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Provider Business Mailing Address
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Address Line | PO BOX 3129
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City | TORRANCE
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State | CA
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Zip | 90510-3129
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Country | US
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Telephone | 310-792-3914
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Fax | 855-898-4055
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY THUE
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Credential | MD
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Telephone | 310-792-3914
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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 | G62084
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License Number State | CA
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