Organization
FIDERE ANESTHESIA CONSULTANTS, INC.
Active
Other names
FREMONT ANESTHESIA CONSULTANTS MEDICAL GROUP, INC.
Organization subpart
No
Provider details
NPI number
Authorized official
KAHTY KONDAS (AO)
(954) 838-2371
Entity
Organization
Contact information
Practice address
2500 GRANT RD, MOUNTAIN VIEW, CA 94040
(650) 903-9500
(650) 903-9900
Mailing address
PO BOX 744653, ATLANTA, GA 30374-4653
(866) 678-4320
(650) 903-9900
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0042170
—
CA
01
—
ZZZ18212Z
BLUE SHIELD
CA
Enumeration date
11/09/2006
Last updated
12/18/2020
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