St. Vincent Anesthesia Medical Group, Inc.

Organization Active NPI Anesthesiology Physician · Los Angeles, CA

NPI 1164535571 · NPPES record last updated May 3, 2021

Key facts

NPI
1164535571
Entity type
Organization (NPI type 2)
Primary specialty
Anesthesiology Physician 207L00000X
Legal business name
ST. VINCENT ANESTHESIA MEDICAL GROUP, INC.
Practice address
2131 W 3Rd St
Los Angeles, CA 90057-1901
Phone
(213) 484-7111
Fax
(213) 484-5525
NPI assigned
Aug 17, 2006
Organization subpart
No

Authorized official

Name
Kathy Kondas
Title
Officer
Phone
(818) 845-6206

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

555 S 7th Ave
#1112
Barstow, CA 92311
Phone (760) 256-1761

10904 Reagan St
#1182
Los Alamitos, CA 90720
Phone (562) 596-3140

2131 W 3rd St
#1182
Los Angeles, CA 90057
Phone (213) 484-7111

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD
    Plans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207L00000X Yes

Addresses

Primary practice location

2131 W 3Rd St
Los Angeles, CA 90057-1901

Mailing address

101 S 1St St
1000
Burbank, CA 91502-1938
Phone (818) 845-6206

Other practice location 1

10921 Cherry St Ste 100
Los Alamitos, CA 90720-2473
Phone (562) 795-5600

Other identifiers

IdentifierTypeStateIssuer
GR0101590MedicaidCA
ZZZ65160ZOtherCABLUE SHIELD

Other providers in Los Angeles, CA

All providers in Los Angeles, CA · Anesthesiology Physician in California

Sources for this page

Verify at the official NPI Registry.