Provider Demographics
NPI:1053456970
Name:CAREY, TONY ANTHONY (DO)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:ANTHONY
Last Name:CAREY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 CENTER STREET
Mailing Address - Street 2:
Mailing Address - City:TAFT
Mailing Address - State:CA
Mailing Address - Zip Code:93268-3511
Mailing Address - Country:US
Mailing Address - Phone:661-765-1122
Mailing Address - Fax:661-765-1123
Practice Address - Street 1:422 CENTER ST
Practice Address - Street 2:
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-3511
Practice Address - Country:US
Practice Address - Phone:661-765-1122
Practice Address - Fax:661-765-1123
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6032207Q00000X, 207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE98168Medicare UPIN