Bayside Anesthesia Medical Group

LBN: Bayside Anesthesia Medical Group
Bayside Anesthesia Medical Group is an health care organization with primary practice located at 1328 22Nd St , Santa Monica CA 90404-2032. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as the primary health care specialty. Bayside Anesthesia Medical Group can be contacted via phone (310) 829-8202, or through Sacks, Kenneth R. via phone (310) 440-3131.

Contact Information

Primary practice address
1328 22Nd St Santa Monica CA 90404-2032
Phone: (310) 829-8202
Fax: (310) 829-8209
Website:
Map and Directions
Authorized official contact:
Name: Sacks, Kenneth R. Doctor of Medicine (MD)
Phone: (310) 440-3131

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X

Profile Details

NPI number 1184668469
LBN Legal business name Bayside Anesthesia Medical Group
DBA Doing business as
Authorized official Sacks, Kenneth R. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 16th, 2006
Last updated Sep 9th, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184668469 NPPES
California MEDICAID GR0062790

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