NPIMap

Organization Active NPI

Palmdale Anesthesia, Inc

  • Anesthesiology Physician
  • Palmdale, CA
National Provider Identifier
1205698115
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PALMDALE ANESTHESIA, INC
Practice address
38600 Medical Center Dr
Palmdale, CA 93551-4483
Phone
(661) 382-5000
NPI assigned
Jan 25, 2024
Last updated
Jan 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Irv Edwards, MD
Title
Ceo
Phone
(310) 321-0143

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

38600 Medical Center Dr
Palmdale, CA 93551-4483

Mailing address

898 N Pacific Coast Hwy Ste 600
El Segundo, CA 90245-2747
Phone (310) 698-5452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240403003660 CA Part B Supplier - Clinic/Group Practice 4385082734 Receives reassigned benefits from 22 practitioners
Practice locations: Palmdale, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1205698115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "898 N PACIFIC COAST HWY STE 600",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452747",
            "telephone_number": "310-698-5452",
            "fax_number": "310-379-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38600 MEDICAL CENTER DR",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514483",
            "telephone_number": "661-382-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMDALE ANESTHESIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "IRV",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-321-0143",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.