MEDICARE: DR. JOHN ONSSY ANIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	A77310	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548208978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN ONSSY ANIS M.D.

Provider Business Mailing Address
First Line	:	914 ARIZONA AVE
Second Line	:	#1
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-1849
Country	:	US
Telephone Number	:	310-592-5323
Fax Number	:

Provider Business Practice Location Address
First Line	:	4929 VAN NUYS BLVD
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-1702
Country	:	US
Telephone Number	:	818-907-4570
Fax Number	:	818-907-2814

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	04/26/2010

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