Organization
ANESTHESIA MEDICAL GRP OF SO CA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BEUTTLER MD (INCORPORATOR)
(209) 473-6555
Entity
Organization
Contact information
Practice address
227 W JANSS RD, SUITE #240, THOUSAND OAKS, CA 91360-1848
(805) 371-0455
Mailing address
2590 E MAIN ST, SUITE # 201, VENTURA, CA 93003-2619
(805) 643-3030
(805) 643-3036
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CA
Enumeration date
02/18/2013
Last updated
03/04/2013
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