Provider Demographics
NPI:1164463055
Name:ANESTHESIA CONSULTANTS OF CALIFORNIA MEDICAL GROUP INC
Entity Type:Organization
Organization Name:ANESTHESIA CONSULTANTS OF CALIFORNIA MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:ENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-673-6100
Mailing Address - Street 1:16955 VIA DEL CAMPO
Mailing Address - Street 2:STE 215
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127
Mailing Address - Country:US
Mailing Address - Phone:858-673-6100
Mailing Address - Fax:858-673-6113
Practice Address - Street 1:555 E VALLEY PARKWAY
Practice Address - Street 2:PALOMAR MEDICAL CENTER
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025
Practice Address - Country:US
Practice Address - Phone:760-739-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0063470Medicaid
CAW13376Medicare ID - Type Unspecified