Provider Demographics
NPI:1639174816
Name:ANTEBI, ALON (DO)
Entity Type:Individual
Prefix:DR
First Name:ALON
Middle Name:
Last Name:ANTEBI
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 1:42135 10TH ST W
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-7095
Mailing Address - Country:US
Mailing Address - Phone:661-726-5005
Mailing Address - Fax:661-726-5377
Practice Address - Street 1:42135 10TH ST W
Practice Address - Street 2:SUITE 101
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-7095
Practice Address - Country:US
Practice Address - Phone:661-726-5005
Practice Address - Fax:661-726-5377
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8890207XX0801X
CA20A8954207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW20A8954AOtherMEDICARE PROV #
CA061742929OtherBC OF CA
FL269326700Medicaid
CAP00260096OtherRR MEDICARE
CA020A89540OtherBS OF CA
CAI15007OtherUPIN
CA00AX89540OtherMEDI-CAL
CAP00260096OtherRR MEDICARE