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General NPI Number Information
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NPI Number | 1750894796
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Entity Type | Organization
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Legal Business Name | GRAND ANESTHESIA AND NURSING SERVICES INC
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Dates
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Enumeration Date | 11/13/2017
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Last Update Date | 11/13/2017
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Provider Practice Location Address
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Address Line | 648 N ST ANDREWS PL
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City | LOS ANGELES
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State | CA
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Zip | 90004-1704
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Country | US
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Telephone | 310-448-2693
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3736
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-0736
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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 | PRESIDENT
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Name | CHRISTY DAVIS
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Credential |
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Telephone | 310-779-3025
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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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