Basic Information
| Provider Information | |||||||||
| NPI: | 1124346374 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | J. SOMAL, M.D. ANESTHESIA, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 81349 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850691349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239311225 | ||||||||
| FaxNumber: | 6239310088 | ||||||||
| Practice Location | |||||||||
| Address1: | 19829 N 27TH AVE | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850274001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239311225 | ||||||||
| FaxNumber: | 6239310088 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2010 | ||||||||
| LastUpdateDate: | 05/12/2010 | ||||||||
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| AuthorizedOfficialLastName: | SOMAL | ||||||||
| AuthorizedOfficialFirstName: | JASJEET | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6239311225 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 37144 | AZ | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.