Healthcare Provider Details

I. General information

NPI: 1831283837
Provider Name (Legal Business Name): ANTHONY CHERIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 11/18/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 S MAIN ST
ORANGE CA
92868-3835
US

IV. Provider business mailing address

455 S MAIN ST
ORANGE CA
92868-3835
US

V. Phone/Fax

Practice location:
  • Phone: 714-532-8620
  • Fax: 714-289-4072
Mailing address:
  • Phone: 714-289-4511
  • Fax: 714-289-4788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number258927
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberA71240
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: