Organization
LEAR ANESTHESIA SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL DESTA M.D. (PRESIDENT)
(703) 288-4669
Entity
Organization
Contact information
Practice address
2440 M ST NW, SUITE 401, WASHINGTON, DC 20037-1404
(202) 293-6567
Mailing address
7702 LEAR RD, MC LEAN, VA 22102-2734
(703) 288-4669
(703) 288-4669
Taxonomy
Speciality
Code
Description
License number
State
261QA0006X
Ambulatory Fertility Facility
Primary
MD30939
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034597900
—
DC
Enumeration date
04/26/2008
Last updated
04/26/2008
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