Basic Information
| Provider Information | |||||||||
| NPI: | 1972634020 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WEST COAST ANESTHESIA INC A MEDICAL GROUP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 HOLLAND STE 101 | ||||||||
| Address2: | |||||||||
| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926182568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9495882190 | ||||||||
| FaxNumber: | 9495882199 | ||||||||
| Practice Location | |||||||||
| Address1: | 23961 CALLE DE LA MAGDALENA | ||||||||
| Address2: | SUITE 541 | ||||||||
| City: | LAGUNA HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926533616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9492875600 | ||||||||
| FaxNumber: | 9496422758 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2007 | ||||||||
| LastUpdateDate: | 01/11/2022 | ||||||||
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| AuthorizedOfficialLastName: | ALUZRI | ||||||||
| AuthorizedOfficialFirstName: | GHADA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9495882190 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 01/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A48738A | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.