Healthcare Provider Details

I. General information

NPI: 1972556108
Provider Name (Legal Business Name): ANTHONY DAVID DEBS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 12/14/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 FOREST AVE
SAN JOSE CA
95128-1425
US

IV. Provider business mailing address

PO BOX 34940
SEATTLE WA
98124-1940
US

V. Phone/Fax

Practice location:
  • Phone: 408-947-2500
  • Fax:
Mailing address:
  • Phone: 503-372-2740
  • Fax: 503-372-2754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG71007
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberG71007
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: