Provider Demographics
NPI:1164812673
Name:ALPINE ANESTHESIA LLC
Entity Type:Organization
Organization Name:ALPINE ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARAYCOCHEA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-368-0468
Mailing Address - Street 1:322 KAREN AVE
Mailing Address - Street 2:UNIT 1207
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-0412
Mailing Address - Country:US
Mailing Address - Phone:801-368-0468
Mailing Address - Fax:801-880-3841
Practice Address - Street 1:322 KAREN AVE
Practice Address - Street 2:UNIT 1207
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-0412
Practice Address - Country:US
Practice Address - Phone:801-368-0468
Practice Address - Fax:801-880-3841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty