Organization
PORTOLA ANESTHESIA SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AIMEE DIDION (ACCOUNTING)
(949) 837-3338
Entity
Organization
Contact information
Practice address
29300 PORTOLA PKWY, SUITE B, LAKE FOREST, CA 92630-8718
(949) 837-3338
(949) 716-2725
Mailing address
29300 PORTOLA PKWY, SUITE B, LAKE FOREST, CA 92630-8718
(949) 837-3338
(949) 716-2725
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/23/2010
Last updated
04/23/2010
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