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General NPI Number Information
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NPI Number | 1609327634
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Entity Type | Organization
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Legal Business Name | OASIS ANESTHESIA LLC
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Dates
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Enumeration Date | 10/14/2016
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 130 COPA DE ORO DR
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City | BREA
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State | CA
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Zip | 92823-7013
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Country | US
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Telephone | 202-251-6521
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Fax |
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Provider Business Mailing Address
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Address Line | 130 COPA DE ORO DR
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City | BREA
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State | CA
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Zip | 92823-7013
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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 | CRNA
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Name | RYLAN REYNOLDS
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Credential | CRNA, DNAP
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Telephone | 202-251-6521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | CA
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