Provider Demographics
NPI:1851986863
Name:BEDFORD ANESTHESIA INC.
Entity Type:Organization
Organization Name:BEDFORD ANESTHESIA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:KYOUNGCHUL
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-902-6811
Mailing Address - Street 1:436 N BEDFORD DR STE 305
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4320
Mailing Address - Country:US
Mailing Address - Phone:310-205-3646
Mailing Address - Fax:310-271-6996
Practice Address - Street 1:436 N BEDFORD DR STE 305
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4320
Practice Address - Country:US
Practice Address - Phone:310-205-3646
Practice Address - Fax:310-271-6996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty