Organization
BLUE EAGLE ANESTHESIA INC A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. YI CHING CHIANG DO (GROUP PRESIDENT)
(650) 991-2000
Entity
Organization
Contact information
Practice address
901 CAMPUS DR, SUITE 102, DALY CITY, CA 94015-4900
(650) 991-2000
(650) 755-8638
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Enumeration date
11/01/2006
Last updated
03/14/2012
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