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Organization
VERDUGO HILLS ANESTHESIA MEDICAL GROUP INC.
Active
Organization
VERDUGO HILLS ANESTHESIA MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN J MCILVENA M.D. (PRESIDENT / AUTHORIZED OFFICIAL)
(626) 795-6596
Entity
Organization
Contact information
Practice address
1812 VERDUGO BLVD, GLENDALE, CA 91208-1407
(818) 952-2214
(818) 952-4618
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
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0055000
—
CA
01
—
ZZZ36723Z
BLUE SHIELD
CA
Enumeration date
07/30/2006
Last updated
03/25/2015
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