NPIMap

Organization Active NPI

Corona Anesthesia Group, Inc.

  • Anesthesiology Physician
  • Corona, CA
National Provider Identifier
1558865840
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
CORONA ANESTHESIA GROUP, INC.
Practice address
800 S Main St
Corona, CA 92882-3420
Phone
(310) 321-0143
Fax
(310) 379-4856
NPI assigned
Mar 21, 2018
Last updated
Aug 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Authorized official

Name
Irv Edwards, MDNPI 1568400513
Title
President
Phone
(310) 321-0143

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

800 S Main St
Corona, CA 92882-3420

Mailing address

PO Box 80181
City of Industry, CA 91716-8181
Phone (310) 321-0143

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180521002362 CA Part B Supplier - Clinic/Group Practice 7416212576 Receives reassigned benefits from 69 practitioners
Practice locations: Corona, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 70

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 70

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1558865840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80181",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917168181",
            "telephone_number": "310-321-0143",
            "fax_number": "310-379-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S MAIN ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823420",
            "telephone_number": "310-321-0143",
            "fax_number": "310-379-4856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONA ANESTHESIA GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-21",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "IRV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-321-0143",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; 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.