MEDICARE: DR. ANTHONY HUGO CONCIATORI D.O.

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	2084P0800X	Psychiatry Physician	A12365	CA
2	2084P0804X	Child & Adolescent Psychiatry Physician	20A12365	CA

General Provider Information

NPI Number	:	1982838900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY HUGO CONCIATORI D.O.

Provider Business Mailing Address
First Line	:	13058 BLOOMFIELD ST
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-1403
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 S TUSTIN ST BLDG D
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92866-2550
Country	:	US
Telephone Number	:	714-289-3936
Fax Number	:

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

Provider Enumeration Date	:	05/05/2009
Last Update Date	:	08/15/2024

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