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Organization
SOUTHLAND ANESTHESIA MEDICAL GROUP
Active
Organization
SOUTHLAND ANESTHESIA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SMITH (MD)
(949) 588-2190
Entity
Organization
Contact information
Practice address
725 S ORANGE AVE, WEST COVINA, CA 91790-2614
(626) 338-8481
Mailing address
26816 VISTA TER, LAKE FOREST, CA 92630-8115
(949) 588-2190
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A43136
CA
Other
Enumeration date
08/18/2006
Last updated
08/22/2020
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