Portola Anesthesia Services LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

PORTOLA ANESTHESIA SERVICES LLC

Practice address

29300 Portola Pkwy
Suite B
Lake Forest, CA 92630-8718

Phone

(949) 837-3338

Fax

(949) 716-2725

NPI assigned

Apr 23, 2010

Organization subpart

No

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

Authorized official

Name

Aimee Didion

Title

Accounting

Phone

(949) 837-3338

Specialties & licenses 1

Addresses

Tax ID family

Portola Anesthesia Services LLC2 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.

• Portola Anesthesia Services, LLC

  • Anesthesiology Physician
  • Mission Viejo, CA
  • NPI 1366510976
  NPD tax ID

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1700103223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29300 PORTOLA PKWY",
            "address_2": "SUITE B",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308718",
            "telephone_number": "949-837-3338",
            "fax_number": "949-716-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29300 PORTOLA PKWY",
            "address_2": "SUITE B",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308718",
            "telephone_number": "949-837-3338",
            "fax_number": "949-716-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTOLA ANESTHESIA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "DIDION",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_title_or_position": "ACCOUNTING",
        "authorized_official_telephone_number": "949-837-3338"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Terry Plevin, PT, DC
• Maeralyn Pogoso
• Oana-Diana Popescu, PA
• Aaron Porter
• Gina-Marie Cimmarrusti Porter, MFTI, AT
• Portola Medical Services PC (Clineva Urgent Care)
• Gilbert M Portugal, D.C.
• Megan Elizabeth Poupard, LMFT
• Sam Pourbabak, MD
• Monica Marie Powers, PSYD

• Medical Specialty Clinic/Center in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.