Southland Anesthesia Medical Group

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A43136 Issued in CA

Legal business name

SOUTHLAND ANESTHESIA MEDICAL GROUP

Practice address

725 S Orange Ave
West Covina, CA 91790-2614

Phone

(626) 338-8481

NPI assigned

Aug 18, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Smith

Title

MD

Phone

(949) 588-2190

Specialties & licenses 1

Addresses

Locations

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": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922112929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26816 VISTA TER",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308115",
            "telephone_number": "949-588-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S ORANGE AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902614",
            "telephone_number": "626-338-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND ANESTHESIA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "949-588-2190"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A43136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Soto
• Micahel Anthony Soto, LPT
• Allison Lee Sou
• Southern California Gastroenteroloy & Hepatology
• Southern California Specialty Care, LLC
• Special Service for Groups, Inc.
• Specialty Eye Care Medical Center, Inc.
• Spectera
• Spring Living Inc (Storm Haven)
• Spring Living Inc (Dore Home)

• Anesthesiology Physician in West Covina, CA
• Providers in West Covina, 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.