Healthcare Provider Details

I. General information

NPI: 1598255465
Provider Name (Legal Business Name): KAREN ANTWILER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67780 E PALM CANYON DR
CATHEDRAL CITY CA
92234-5441
US

IV. Provider business mailing address

67555 E PALM CANYON DR STE C113
CATHEDRAL CITY CA
92234-5412
US

V. Phone/Fax

Practice location:
  • Phone: 760-773-4300
  • Fax: 760-837-8994
Mailing address:
  • Phone: 760-773-4300
  • Fax: 760-773-4285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberA178391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: