Provider Demographics
NPI:1588938971
Name:SUMMIT ANESTHESIA MEDICAL GROUP INC
Entity type:Organization
Organization Name:SUMMIT ANESTHESIA MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KALI
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHAUDHURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-652-8700
Mailing Address - Street 1:1225 E LATHAM AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4423
Mailing Address - Country:US
Mailing Address - Phone:951-652-8700
Mailing Address - Fax:951-766-9944
Practice Address - Street 1:1117 E DEVONSHIRE AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3083
Practice Address - Country:US
Practice Address - Phone:951-652-8700
Practice Address - Fax:951-766-9944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty