Provider Demographics
NPI:1003947391
Name:METRO ANESTHESIA CONSULTANTS P C
Entity Type:Organization
Organization Name:METRO ANESTHESIA CONSULTANTS P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WHOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-200-9021
Mailing Address - Street 1:PO BOX 80042
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91716-8042
Mailing Address - Country:US
Mailing Address - Phone:602-200-9021
Mailing Address - Fax:602-200-9087
Practice Address - Street 1:1625 E NORTHERN AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-3960
Practice Address - Country:US
Practice Address - Phone:602-200-9021
Practice Address - Fax:602-200-9087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty