Basic Information
| Provider Information | |||||||||
| NPI: | 1427470053 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LA QUALITY CARE ANESTHESIA CONSULTANTS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 60790 | ||||||||
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| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911166790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6267956596 | ||||||||
| FaxNumber: | 6267958247 | ||||||||
| Practice Location | |||||||||
| Address1: | 5700 SAN FERNANDO RD | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 912022104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8186377766 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2014 | ||||||||
| LastUpdateDate: | 01/16/2014 | ||||||||
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| AuthorizedOfficialLastName: | ASHOUR | ||||||||
| AuthorizedOfficialFirstName: | SYLVIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD/AUTHORIZED OFFICAL | ||||||||
| AuthorizedOfficialTelephone: | 3232448066 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.