Provider Demographics
NPI:1750016531
Name:ANESTHESIA SERVICES OF AMERICA LLC
Entity type:Organization
Organization Name:ANESTHESIA SERVICES OF AMERICA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KHARAZZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-653-9399
Mailing Address - Street 1:PO BOX 2137
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85372-2137
Mailing Address - Country:US
Mailing Address - Phone:908-653-9399
Mailing Address - Fax:908-653-9305
Practice Address - Street 1:14155 N 83RD AVE STE 140
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-5652
Practice Address - Country:US
Practice Address - Phone:605-510-3203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty