Healthcare Provider Details

I. General information

NPI: 1891455051
Provider Name (Legal Business Name): ANTHONY ARNETT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2021
Last Update Date: 12/29/2021
Certification Date: 12/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 25TH ST
SAN DIEGO CA
92102-2107
US

IV. Provider business mailing address

45630 MUIRFIELD DR
TEMECULA CA
92592-6061
US

V. Phone/Fax

Practice location:
  • Phone: 233-619-0067
  • Fax:
Mailing address:
  • Phone: 951-834-3213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246YR1600X
TaxonomyRegistered Record Administrator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: