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Organization
SOCAL ANESTHSIA CONSULTANTS MEDICAL GROUP, INC.
Active
Organization
SOCAL ANESTHSIA CONSULTANTS MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS A. RICO M.D. (PRESIDENT)
(626) 795-6596
Entity
Organization
Contact information
Practice address
1420 S CENTRAL AVE, GLENDALE, CA 91204-2508
(818) 502-1900
(818) 502-4738
Mailing address
PO BOX 60790, PASADENA, CA 91116-6790
(626) 795-6596
(626) 795-8247
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ54894Y
BLUE SHIELD
CA
Enumeration date
05/12/2008
Last updated
10/14/2009
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