Organization
ALLIED ANESTHESIA MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAVEH MATIN M.D. (PRESIDENT / AUTHORIZED OFFICIAL)
(714) 619-4730
Entity
Organization
Contact information
Practice address
1100 W STEWART DR, ORANGE, CA 92868-3849
(714) 633-9111
(714) 744-8695
Mailing address
PO BOX 1628, ORANGE, CA 92856-0628
(714) 560-1580
(714) 560-1585
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0059140
—
CA
01
—
ZZZ40419Z
BLUE SHIELD
CA
Enumeration date
07/16/2006
Last updated
02/19/2015
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