Advanced Anesthesia Medical Group Inc

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

A64236 Issued in CA

Legal business name

ADVANCED ANESTHESIA MEDICAL GROUP INC

Practice address

18800 Delaware St
Suite 670
Huntington Beach, CA 92648-1959

Phone

(714) 841-4400

Fax

(714) 841-4414

NPI assigned

Oct 1, 2009

Organization subpart

No

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

Authorized official

Name

Magued R Fadly, MD

Title

President

Phone

(714) 841-4400

Specialties & licenses 1

Addresses

Tax ID family

Advanced Anesthesia Medical Group Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Advanced Anesthesia Medical Group, Inc

  • Pain Medicine (Anesthesiology) Physician
  • West Hills, CA
  • NPI 1104373281
  NPD tax ID

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1093049413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18800 DELAWARE ST",
            "address_2": "SUITE 670",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481959",
            "telephone_number": "714-841-4400",
            "fax_number": "714-841-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18800 DELAWARE ST",
            "address_2": "SUITE 670",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481959",
            "telephone_number": "714-841-4400",
            "fax_number": "714-841-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ANESTHESIA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-01",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "FADLY",
        "authorized_official_first_name": "MAGUED",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-841-4400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A64236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Anesthesiology) Physician in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Pain Medicine (Anesthesiology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.