Healthcare Provider Details

I. General information

NPI: 1962474247
Provider Name (Legal Business Name): ANTHONY M DEBEUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2446 W WHITTIER BLVD
MONTEBELLO CA
90640-3041
US

IV. Provider business mailing address

2446 W WHITTIER BLVD
MONTEBELLO CA
90640-3041
US

V. Phone/Fax

Practice location:
  • Phone: 626-831-8770
  • Fax:
Mailing address:
  • Phone: 323-728-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number28334
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number28334
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberG84475
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: