Organization
APPLE VALLEY ANESTHESIA MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENILDA DE ASIS M.D. (PRESIDENT)
(760) 946-3210
Entity
Organization
Contact information
Practice address
18300 HWY 18, APPLE VALLEY, CA 92307-2206
(760) 242-2311
(760) 242-9167
Mailing address
101 S 1ST ST, 1000, BURBANK, CA 91502-1938
(818) 845-6206
(818) 845-9774
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0091390
—
CA
01
—
ZZZ03117Z
BLUE SHIELD
CA
Enumeration date
08/02/2006
Last updated
08/22/2020
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