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General NPI Number Information
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NPI Number | 1952938540
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Entity Type | Individual
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Provider Name | ANTHONY A OBISESAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 2451 UNIVERSITY HOSPITAL DR MASTIN BUILDING RM 315
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City | MOBILE
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State | AL
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Zip | 36617-2300
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Country | US
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Telephone | 351-471-7866
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 W CARSON ST
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City | TORRANCE
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State | CA
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Zip | 90502-2004
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Country | US
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Telephone |
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | L.5130R
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A200318
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License Number State | CA
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