Organization
GROSSMONT ANESTHESIA SERVICES MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER KOURAJIAN MD (PRESIDENT)
(619) 460-5111
Entity
Organization
Contact information
Practice address
5555 GROSSMONT CENTER DR, LA MESA, CA 91942
(619) 456-0711
Mailing address
8893 LA MESA BLVD SUITE D, PO BOX 3617, LA MESA, CA 91944-3617
(619) 460-5111
(619) 460-7815
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0064000
—
CA
Enumeration date
12/04/2006
Last updated
08/22/2020
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