Organization
ELITE ANESTHESIA MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK M AHN M.D. (PRESIDENT)
(800) 883-7243
Entity
Organization
Contact information
Practice address
9400 N NAME UNO, GILROY, CA 95020-3528
(408) 848-2000
Mailing address
210 N TUSTIN AVE, SANTA ANA, CA 92705-3807
(714) 347-1000
(714) 647-1245
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
FNP 30520
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0093550
—
CA
Enumeration date
05/13/2006
Last updated
06/27/2015
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