Provider Demographics
NPI:1003485384
Name:ANESTHESIA ON DEMAND - A PROFESSIONAL NURSING CORPORATION
Entity type:Organization
Organization Name:ANESTHESIA ON DEMAND - A PROFESSIONAL NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CIAMAICHELO
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:310-897-8429
Mailing Address - Street 1:PO BOX 25033
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92799-5033
Mailing Address - Country:US
Mailing Address - Phone:714-347-1000
Mailing Address - Fax:714-347-1082
Practice Address - Street 1:801 S CHEVY CHASE DR STE 106
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-4437
Practice Address - Country:US
Practice Address - Phone:818-265-2275
Practice Address - Fax:818-649-1034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty