Basic Information
Provider Information
NPI: 1083989909
EntityType: 2
ReplacementNPI:  
OrganizationName: MADING ANESTHESIA SERVICES
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Mailing Information
Address1: PO BOX 969096
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921969096
CountryCode: US
TelephoneNumber: 8584950971
FaxNumber: 8584950991
Practice Location
Address1: 27462 PORTOLA PKWY STE 101
Address2:  
City: FOOTHILL RANCH
State: CA
PostalCode: 926102838
CountryCode: US
TelephoneNumber: 9499001340
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/09/2012
LastUpdateDate: 03/17/2018
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AuthorizedOfficialLastName: MADING
AuthorizedOfficialFirstName: WILLIAM
AuthorizedOfficialMiddleName: CHARLES
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 9492123194
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XG063263CAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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