MEDICARE: ALPINE ANESTHESIA LLC

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
1	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1164812673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPINE ANESTHESIA LLC

Provider Business Mailing Address
First Line	:	322 KAREN AVE
Second Line	:	UNIT 1207
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-0412
Country	:	US
Telephone Number	:	801-368-0468
Fax Number	:	801-880-3841

Provider Business Practice Location Address
First Line	:	322 KAREN AVE
Second Line	:	UNIT 1207
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-0412
Country	:	US
Telephone Number	:	801-368-0468
Fax Number	:	801-880-3841

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHRISTIAN GARAYCOCHEA
Credential	:	M.D.
Telephone Number	:	801-368-0468

Provider Enumeration Date	:	02/04/2015
Last Update Date	:	04/21/2015

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Directions to “ALPINE ANESTHESIA LLC ” Practice Location

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