MEDICARE: PAR ANESTHESIA

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	282N00000X	General Acute Care Hospital	A110754	CA

General Provider Information

NPI Number	:	1427455856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAR ANESTHESIA

Provider Business Mailing Address
First Line	:	1125 GRANVIA ALTAMIRA
Second Line	:
City	:	PALOS VERDES ESTATES
State	:	CA
Zip	:	90274-2001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1125 GRANVIA ALTAMIRA
Second Line	:
City	:	PALOS VERDES ESTATES
State	:	CA
Zip	:	90274-2001
Country	:	US
Telephone Number	:	310-704-9195
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MERTON GOODE
Credential	:	M.D.
Telephone Number	:	415-668-1000

Provider Enumeration Date	:	12/01/2014
Last Update Date	:	12/01/2014

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Directions to “PAR ANESTHESIA ” Practice Location

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