Portola Anesthesia Services LLC
NPI #1700103223 in Lake Forest, California
Provider Information
- NPI Number
- 1700103223
- Entity Type
- Organization
- Organization Name
- Portola Anesthesia Services LLC
- Primary Specialty
- Clinic/Center - Medical Specialty
- Enumeration Date
- Apr 23, 2010
- Last Updated
- Apr 23, 2010
Practice Location
- Address
- 29300 PORTOLA PKWY
- Address 2
- SUITE B
- City
- Lake Forest
- State
- California
- ZIP Code
- 92630-8718
- Phone
- (949) 837-3338
Authorized Official
- Name
- AIMEE DIDION
- Title
- ACCOUNTING
- Phone
- (949) 837-3338
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Medical Specialty — Medical Specialty |
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