Healthcare Provider Details
I. General information
NPI: 1295716165
Provider Name (Legal Business Name): ALON ANTEBI, DO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2005
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
44105 15TH STREET WEST STE 201
LANCASTER CA
93534-4090
US
IV. Provider business mailing address
44105 15TH STREET WEST STE 201
LANCASTER CA
93534-4090
US
V. Phone/Fax
- Phone: 661-726-5005
- Fax: 661-726-5377
- Phone: 661-726-5005
- Fax: 661-726-5377
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALON
ANTEBI
Title or Position: OWNER
Credential: DO
Phone: 661-726-5005