Provider Demographics
NPI:1023858586
Name:CENTURY CITY ANESTHESIA GROUP A PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:CENTURY CITY ANESTHESIA GROUP A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL AND MAXILLOFACIAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:KUPFERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MD, FACS
Authorized Official - Phone:310-842-4811
Mailing Address - Street 1:2080 CENTURY PARK E STE 610
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2009
Mailing Address - Country:US
Mailing Address - Phone:310-842-4811
Mailing Address - Fax:310-286-2177
Practice Address - Street 1:2080 CENTURY PARK E STE 610
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2009
Practice Address - Country:US
Practice Address - Phone:310-842-4811
Practice Address - Fax:310-286-2177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty