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NPI Code Detail

MEDICARE: SAFE ANESTHESIA MEDICAL GROUP

MEDICARE: SAFE ANESTHESIA MEDICAL GROUP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianA26350CA

General Provider Information

NPI Number : 1104023365
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAFE ANESTHESIA MEDICAL GROUP
Provider Business Mailing Address
First Line : 269 S BEVERLY DR # 511
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90212-3807
Country : US
Telephone Number : 323-290-0725
Fax Number : 323-290-0727
Provider Business Practice Location Address
First Line : 2231 S WESTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90018-1302
Country : US
Telephone Number : 323-290-0725
Fax Number : 323-290-0727
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. BROWNELL HILLARD PAYNE
Credential : M.D.
Telephone Number : 323-290-0725
Provider Enumeration Date : 06/29/2007
Last Update Date : 08/22/2020

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Directions to “SAFE ANESTHESIA MEDICAL GROUP ” Practice Location

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