Basic Information
| Provider Information | |||||||||
| NPI: | 1861161473 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CITADEL ANESTHESIA INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 25033 | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927995033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7143471000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 16543 CARMENITA RD | ||||||||
| Address2: | |||||||||
| City: | CERRITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907032218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5622197251 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2021 | ||||||||
| LastUpdateDate: | 09/08/2021 | ||||||||
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| AuthorizedOfficialLastName: | FARROHI | ||||||||
| AuthorizedOfficialFirstName: | ALIREZA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3105620913 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 09/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.