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General NPI Number Information
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NPI Number | 1912190752
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Entity Type | Organization
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Legal Business Name | JOHN M. ANASTASATOS M.D., INC.
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 436 N BEDFORD DR SUITE 200
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4310
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Country | US
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Telephone | 310-888-4048
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Fax | 310-888-2827
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Provider Business Mailing Address
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Address Line | 436 N BEDFORD DR SUITE 200
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4310
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Country | US
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Telephone | 310-888-4048
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Fax | 310-888-2827
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN M. ANASTASATOS
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Credential | M.D.
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Telephone | 310-888-4048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | A92907
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License Number State | CA
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