MEDICARE: GILBERT ANESTHESIA SERVICES PLLC

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	:	1265719579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GILBERT ANESTHESIA SERVICES PLLC

Provider Business Mailing Address
First Line	:	600 S DOBSON RD
Second Line	:	BLDG A
City	:	CHANDLER
State	:	AZ
Zip	:	85224-5678
Country	:	US
Telephone Number	:	480-786-6655
Fax Number	:	480-786-6996

Provider Business Practice Location Address
First Line	:	2563 S VAL VISTA DR
Second Line	:	STE 101
City	:	GILBERT
State	:	AZ
Zip	:	85295-6231
Country	:	US
Telephone Number	:	480-786-6655
Fax Number	:	480-786-6996

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. GREGORY H NGUYENDUC
Credential	:	M.D.
Telephone Number	:	480-786-6655

Provider Enumeration Date	:	11/15/2011
Last Update Date	:	11/15/2011

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