Provider Demographics
NPI:1720687395
Name:ANESTHESIA FIRST
Entity Type:Organization
Organization Name:ANESTHESIA FIRST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VADIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SMIRNOV
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA, MD
Authorized Official - Phone:415-290-0489
Mailing Address - Street 1:722 S MANHATTAN PL APT 301
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-3122
Mailing Address - Country:US
Mailing Address - Phone:415-290-0489
Mailing Address - Fax:
Practice Address - Street 1:125 N RAYMOND AVE UNIT 212
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-4535
Practice Address - Country:US
Practice Address - Phone:626-385-4674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-23
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty