Provider Demographics
NPI:1205253929
Name:PRECISION ANESTHESIA GROUP INC
Entity type:Organization
Organization Name:PRECISION ANESTHESIA GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:K
Authorized Official - Last Name:ASSIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-610-2040
Mailing Address - Street 1:450 N ROXBURY DRIVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4240
Mailing Address - Country:US
Mailing Address - Phone:310-651-2040
Mailing Address - Fax:310-651-2042
Practice Address - Street 1:450 N ROXBURY DRIVE
Practice Address - Street 2:SUITE 240
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4240
Practice Address - Country:US
Practice Address - Phone:310-651-2040
Practice Address - Fax:310-651-2042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty