Provident Anesthesia Medical Group Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G46241 Issued in CA

Legal business name

PROVIDENT ANESTHESIA MEDICAL GROUP INC

Practice address

7300 Medical Ctr
West Hills, CA 91307-1902

Phone

(818) 550-0900

Fax

(505) 293-1524

NPI assigned

Feb 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. A Joseph Herbert, M.D.NPI 1942347851

Title

President

Phone

(818) 550-0900

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• A Joseph Herbert, M.D.

  • Anesthesiology Physician
  • West Hills, CA
  • NPI 1942347851
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1063554798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5486",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928635486",
            "telephone_number": "818-550-0900",
            "fax_number": "505-293-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 MEDICAL CTR",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913071902",
            "telephone_number": "818-550-0900",
            "fax_number": "505-293-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENT ANESTHESIA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "HERBERT",
        "authorized_official_first_name": "A JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-550-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G46241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ56463Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in West Hills, CA
• Providers in West Hills, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.