Organization
GLENDALE ANESTHESIA CONSULTANTS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID THEIN M.D. (PRESIDENT)
(626) 795-6596
Entity
Organization
Contact information
Practice address
1420 S CENTRAL AVE, GLENDALE, CA 91204-2508
(818) 502-2252
(818) 502-2317
Mailing address
225 S LAKE AVE, 535, PASADENA, CA 91101-3005
(626) 795-6596
(626) 795-8247
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0084110
—
CA
01
—
ZZZ01551Z
BLUE SHIELD
CA
Enumeration date
07/26/2006
Last updated
08/22/2020
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