Provider Demographics
NPI:1629199427
Name:CELONA, ANNE F (PAC)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:F
Last Name:CELONA
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5204
Mailing Address - Street 2:SUITE 626
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91117-0204
Mailing Address - Country:US
Mailing Address - Phone:626-808-3071
Mailing Address - Fax:805-494-8385
Practice Address - Street 1:201 S ALVARADO ST
Practice Address - Street 2:SUITE 626
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2320
Practice Address - Country:US
Practice Address - Phone:213-484-5397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16927363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA70948GOtherEAP
CAFHC709486Medicaid
CAFHC709486Medicaid