MEDICARE: CECILIA ANTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC19907	CA

General Provider Information

NPI Number	:	1831964105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILIA ANTON

Provider Business Mailing Address
First Line	:	3962 1ST AVE APT 3
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-3052
Country	:	US
Telephone Number	:	917-447-4379
Fax Number	:

Provider Business Practice Location Address
First Line	:	3962 1ST AVE APT 3
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-3052
Country	:	US
Telephone Number	:	917-447-4379
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2023
Last Update Date	:	11/16/2023

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Directions to “ CECILIA ANTON ” Practice Location

Language	Start Address	Practice Location

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