Organization
PACIFIC ANESTHESIA GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN FARSHAD KOHAN M.D. (OWNER / PRESIDENT)
(818) 788-2400
Entity
Organization
Contact information
Practice address
16260 VENTURA BLVD, STE 800, ENCINO, CA 91436-2203
(818) 788-2400
Mailing address
PO BOX 241295, LOS ANGELES, CA 90024-1295
(818) 788-2400
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/16/2010
Last updated
04/16/2010
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