# CHAGRIN VALLEY ANESTHESIA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528002490
- **Authorized official:** JOHN J FITZGERALD MD (PRESIDENT)
- **Authorized official phone:** (216) 765-0358

## Contact information

- **Practice address:** 3755 ORANGE PL STE 102, BEACHWOOD, OH 44122-4455
- **Practice address phone:** (216) 765-0358
- **Practice address fax:** (216) 765-0378
- **Mailing address:** 3755 ORANGE PL STE 105, BEACHWOOD, OH 44122-4426
- **Mailing address phone:** (216) 765-0358
- **Mailing address fax:** (216) 765-0378

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/15/2006
- **Last updated:** 09/19/2019