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Organization
ST. VINCENT ANESTHESIA MEDICAL GROUP, INC.
Active
Organization
ST. VINCENT ANESTHESIA MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY KONDAS (OFFICER)
(818) 845-6206
Entity
Organization
Contact information
Practice address
2131 W 3RD ST, LOS ANGELES, CA 90057-1901
(213) 484-7111
(213) 484-5525
Mailing address
101 S 1ST ST, 1000, BURBANK, CA 91502-1938
(818) 845-6206
(818) 845-9774
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0101590
—
CA
01
—
ZZZ65160Z
BLUE SHIELD
CA
Enumeration date
08/17/2006
Last updated
05/03/2021
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