Provider Demographics
NPI:1528238128
Name:MORPHEUS ANESTHESIA MEDICAL CORPORATION
Entity type:Organization
Organization Name:MORPHEUS ANESTHESIA MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WING
Authorized Official - Middle Name:CHIU
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-573-4046
Mailing Address - Street 1:PO BOX 1754
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-8754
Mailing Address - Country:US
Mailing Address - Phone:626-573-4046
Mailing Address - Fax:626-441-7316
Practice Address - Street 1:1668 S GARFIELD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-5413
Practice Address - Country:US
Practice Address - Phone:626-308-9000
Practice Address - Fax:626-308-9050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP29187207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty