Provider Demographics
NPI:1831439678
Name:SEDATES, INC
Entity type:Organization
Organization Name:SEDATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:E
Authorized Official - Last Name:PULVER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:310-545-1169
Mailing Address - Street 1:1601 N SEPULVEDA BLVD
Mailing Address - Street 2:#374
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5111
Mailing Address - Country:US
Mailing Address - Phone:310-545-1169
Mailing Address - Fax:
Practice Address - Street 1:465 N ROXBURY DR STE 1001
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4213
Practice Address - Country:US
Practice Address - Phone:310-545-1169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA#2010367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty