Provider Demographics
NPI:1407805310
Name:GENERAL ANESTHESIA SPECIALISTS PARTNERSHIP MEDICAL GROUP
Entity Type:Organization
Organization Name:GENERAL ANESTHESIA SPECIALISTS PARTNERSHIP MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-637-3703
Mailing Address - Street 1:3530 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2328
Mailing Address - Country:US
Mailing Address - Phone:213-637-3703
Mailing Address - Fax:213-427-3659
Practice Address - Street 1:8700 BEVERLY BLVD
Practice Address - Street 2:SUITE 8211
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:213-637-3703
Practice Address - Fax:213-427-3659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW11706Medicare ID - Type Unspecified