Organization
INDEPENDENT ANESTHESIOLOGY, A MEDICAL GROUP
Active
Other names
IAMG
Organization subpart
No
Provider details
NPI number
Authorized official
MS. COLLEEN WILLIAMS (AGENT)
(714) 992-4444
Entity
Organization
Contact information
Practice address
1001 N TUSTIN AVE, SANTA ANA, CA 92705-3502
(714) 835-3555
(714) 953-3542
Mailing address
PO BOX 10790, SANTA ANA, CA 92711-0790
(714) 992-4444
(714) 879-9999
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0066370
—
CA
01
—
ZZZ47026Z
BLUE SHIELD
CA
Enumeration date
02/17/2007
Last updated
08/22/2020
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