# PORTOLA ANESTHESIA SERVICES LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1700103223
- **Authorized official:** AIMEE DIDION (ACCOUNTING)
- **Authorized official phone:** (949) 837-3338

## Contact information

- **Practice address:** 29300 PORTOLA PKWY, SUITE B, LAKE FOREST, CA 92630-8718
- **Practice address phone:** (949) 837-3338
- **Practice address fax:** (949) 716-2725
- **Mailing address:** 29300 PORTOLA PKWY, SUITE B, LAKE FOREST, CA 92630-8718
- **Mailing address phone:** (949) 837-3338
- **Mailing address fax:** (949) 716-2725

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 04/23/2010
- **Last updated:** 04/23/2010