NPIMap

Organization Active NPI

South Bay Nurse Anesthesia Services

  • Anesthesiology Physician
  • Redondo Beach, CA
National Provider Identifier
1669811378
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
513220 Issued in CA
Legal business name
SOUTH BAY NURSE ANESTHESIA SERVICES
Practice address
510 N Prospect Ave Ste 202
Redondo Beach, CA 90277-3030
Phone
(310) 722-7348
NPI assigned
Jun 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Authorized official

Name
Ms. Grace H Wakugawa, CRNA
Title
Owner
Phone
(310) 722-7348

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 513220 CA Primary

Addresses

Primary practice location

510 N Prospect Ave Ste 202
Redondo Beach, CA 90277-3030

Mailing address

PO Box 3144
Palos Verdes Peninsula, CA 90274-9144
Phone (310) 722-7348

Other names 1

  • Grace and Wellness Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371427200000",
    "number": "1669811378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3144",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902749144",
            "telephone_number": "310-722-7348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N PROSPECT AVE STE 202",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773030",
            "telephone_number": "310-722-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY NURSE ANESTHESIA SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-17",
        "last_updated": "2013-06-17",
        "status": "A",
        "authorized_official_last_name": "WAKUGAWA",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-722-7348",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "513220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace and Wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; 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.