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Organization
PRIMERO ANESTHESIA SERVICES MEDICAL CORPORATION
Active
Organization
PRIMERO ANESTHESIA SERVICES MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILO QUITA PRIMERO M.D. (PRESIDENT)
(714) 560-1580
Entity
Organization
Contact information
Practice address
150 W ROUTE 66, GLENDORA, CA 91740-6207
(626) 335-0231
(626) 335-5082
Mailing address
500 S MAIN ST, 1210, ORANGE, CA 92868-4507
(714) 560-1580
(714) 560-1585
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A311701
BLUE SHIELD
CA
05
—
00A311701
—
CA
Enumeration date
08/04/2006
Last updated
03/26/2008
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