MEDICARE: DABISH ANESTHESIA INC

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	A106568	CA

General Provider Information

NPI Number	:	1568964187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DABISH ANESTHESIA INC

Provider Business Mailing Address
First Line	:	210 N TUSTIN AVE
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-3807
Country	:	US
Telephone Number	:	714-347-1000
Fax Number	:	714-647-1245

Provider Business Practice Location Address
First Line	:	361 HOSPITAL RD STE 124
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-3521
Country	:	US
Telephone Number	:	949-631-0988
Fax Number	:	949-631-2504

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CYNTHIA DABISH
Credential	:	MD
Telephone Number	:	714-347-1000

Provider Enumeration Date	:	02/28/2018
Last Update Date	:	02/28/2018

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