Basic Information
Provider Information
NPI: 1568964187
EntityType: 2
ReplacementNPI:  
OrganizationName: DABISH ANESTHESIA INC
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Mailing Information
Address1: 210 N TUSTIN AVE
Address2:  
City: SANTA ANA
State: CA
PostalCode: 927053807
CountryCode: US
TelephoneNumber: 7143471000
FaxNumber: 7146471245
Practice Location
Address1: 361 HOSPITAL RD STE 124
Address2:  
City: NEWPORT BEACH
State: CA
PostalCode: 926633521
CountryCode: US
TelephoneNumber: 9496310988
FaxNumber: 9496312504
Other Information
ProviderEnumerationDate: 02/28/2018
LastUpdateDate: 02/28/2018
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AuthorizedOfficialLastName: DABISH
AuthorizedOfficialFirstName: CYNTHIA
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AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 7143471000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA106568CAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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