=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639174816
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALON ANTEBI DO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2005
-----------------------------------------------------
Last Update Date | 05/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 42135 10TH ST W SUITE 101
-----------------------------------------------------
City | LANCASTER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93534-7095
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-726-5005
-----------------------------------------------------
Fax | 661-726-5377
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 42135 10TH ST W SUITE 101
-----------------------------------------------------
City | LANCASTER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93534-7095
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-726-5005
-----------------------------------------------------
Fax | 661-726-5377
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207XX0801X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Trauma Physician
-----------------------------------------------------
License Number | OS8890
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207XX0801X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Trauma Physician
-----------------------------------------------------
License Number | DO92646
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207XX0801X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Trauma Physician
-----------------------------------------------------
License Number | 20A8954
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------