Provider Demographics
NPI:1376067629
Name:CENTURY ANESTHESIA MEDICAL GROUP
Entity Type:Organization
Organization Name:CENTURY ANESTHESIA MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GADI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARZANIPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-792-3914
Mailing Address - Street 1:PO BOX 39260
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-0260
Mailing Address - Country:US
Mailing Address - Phone:310-792-3914
Mailing Address - Fax:855-898-4055
Practice Address - Street 1:5353 BALBOA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-2863
Practice Address - Country:US
Practice Address - Phone:310-963-9727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty