Intervalley Anesthesia Medical Corporation

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

INTERVALLEY ANESTHESIA MEDICAL CORPORATION

Practice address

150 W Route 66
Glendora, CA 91740-6207

Phone

(626) 335-0231

Fax

(626) 335-5082

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Octavius Cuizon Quijada, M.D.

Title

President

Phone

(909) 335-2347

Specialties & licenses 1

Addresses

Other identifiers 2

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: 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)…

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801804208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S MAIN ST",
            "address_2": "1210",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684507",
            "telephone_number": "714-560-1580",
            "fax_number": "714-560-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W ROUTE 66",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406207",
            "telephone_number": "626-335-0231",
            "fax_number": "626-335-5082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVALLEY ANESTHESIA MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "QUIJADA",
        "authorized_official_first_name": "OCTAVIUS",
        "authorized_official_middle_name": "CUIZON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-335-2347",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A251370",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A251370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kumiko Inoue, OTR/L
• Integrated Advanced Medicine Inc
• Integrated Nursing and Rehab Care of Glendora Inc.
• Integrative Urgent Care, Inc.
• Integrity Home Care Services LLC
• Ibrahim Irawan, D.D.S.
• Lisa M Irwin
• Modesty Joy Isaguirre, LE
• Earl Scott Isbell, MD
• Jessica Ishak

• Anesthesiology Physician in Glendora, CA
• Providers in Glendora, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.