Provider Demographics
NPI:1093363848
Name:OCANA, ANTHONY MARTIN (MD, CCFP, FASAM)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:MARTIN
Last Name:OCANA
Suffix:
Gender:M
Credentials:MD, CCFP, FASAM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13924 MARQUESAS WAY APT 1520
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6018
Mailing Address - Country:US
Mailing Address - Phone:604-803-8513
Mailing Address - Fax:
Practice Address - Street 1:13924 MARQUESAS WAY APT 1520
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-6018
Practice Address - Country:US
Practice Address - Phone:604-803-8513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC164730207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine