Organization
ETHER MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAANA ANWARUDDIN M.D. (SOLE OWNER/PRESIDENT)
(818) 888-7815
Entity
Organization
Contact information
Practice address
15107 VANOWEN ST, VAN NUYS, CA 91405-4542
(818) 782-6600
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A94730
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
A94730
CA
Other
Enumeration date
10/17/2007
Last updated
05/14/2008
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