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General NPI Number Information
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NPI Number | 1902894314
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Entity Type | Individual
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Provider Name | HUSSAM Y ANTOIN MD
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Gender | Male
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 01/12/2016
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Provider Practice Location Address
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Address Line | 120 S SPALDING DR STE. 301
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-1800
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Country | US
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Telephone | 310-385-7755
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Fax |
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Provider Business Mailing Address
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Address Line | 1326 MILLER DR
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City | LOS ANGELES
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State | CA
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Zip | 90069-1420
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Country | US
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Telephone |
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Fax | 323-848-9557
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A88484
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License Number State | CA
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