Provider Demographics
NPI:1396851903
Name:ANTHONY, VINCENT LUVERN (MD, MPH)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:LUVERN
Last Name:ANTHONY
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 W TEMPLE ST STE 7200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-5421
Mailing Address - Country:US
Mailing Address - Phone:213-484-4929
Mailing Address - Fax:213-484-1948
Practice Address - Street 1:1711 W TEMPLE ST
Practice Address - Street 2:SUITE 7200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-5421
Practice Address - Country:US
Practice Address - Phone:888-522-7311
Practice Address - Fax:213-484-1948
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96566207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA96566OtherCALIFORNIA LICENSE