Healthcare Provider Details

I. General information

NPI: 1770516999
Provider Name (Legal Business Name): LILLI ANN C CELLONA M D A MEDICAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8245 E MONTE VISTA RD STE 200
ANAHEIM CA
92808-1297
US

IV. Provider business mailing address

8245 E MONTE VISTA RD STE 200
ANAHEIM CA
92808-1297
US

V. Phone/Fax

Practice location:
  • Phone: 714-974-0100
  • Fax: 714-974-0300
Mailing address:
  • Phone: 714-974-0100
  • Fax: 714-974-0300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA52283
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: