Healthcare Provider Details

I. General information

NPI: 1548208978
Provider Name (Legal Business Name): JOHN ONSSY ANIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 04/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4929 VAN NUYS BLVD
SHERMAN OAKS CA
91403-1702
US

IV. Provider business mailing address

914 ARIZONA AVE #1
SANTA MONICA CA
90401-1849
US

V. Phone/Fax

Practice location:
  • Phone: 818-907-4570
  • Fax: 818-907-2814
Mailing address:
  • Phone: 310-592-5323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA77310
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: