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Organization
RADIANCE ANESTHESIA GROUP INC.
Active
Organization
RADIANCE ANESTHESIA GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID LEE NICOLAS RN (ADMINISTRATOR)
(818) 565-9802
Entity
Organization
Contact information
Practice address
5170 SEPULVEDA BLVD, SUITE 220, SHERMAN OAKS, CA 91403-1171
(818) 565-9802
(818) 995-8703
Mailing address
5170 SEPULVEDA BLVD, SUITE 220, SHERMAN OAKS, CA 91403-1171
(818) 565-9802
(818) 995-8703
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
CA
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
10/26/2012
Last updated
08/11/2016
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