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General NPI Number Information
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NPI Number | 1538268073
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Entity Type | Individual
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Provider Name | ANTONIOS ISSA M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 750 WELCH RD STE 315
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City | PALO ALTO
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State | CA
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Zip | 94304-1510
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Country | US
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Telephone | 650-723-5711
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Fax | 650-725-8351
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Provider Business Mailing Address
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Address Line | PO BOX 1917
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City | SOQUEL
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State | CA
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Zip | 95073-1917
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Country | US
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Telephone | 831-359-3014
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Fax | 831-462-7761
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | A52946
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License Number State | CA
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