Provider Demographics
NPI:1295716165
Name:ALON ANTEBI, DO, INC.
Entity type:Organization
Organization Name:ALON ANTEBI, DO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALON
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTEBI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:661-726-5005
Mailing Address - Street 1:44105 15TH STREET WEST
Mailing Address - Street 2:STE 201
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4090
Mailing Address - Country:US
Mailing Address - Phone:661-726-5005
Mailing Address - Fax:661-726-5377
Practice Address - Street 1:44105 15TH STREET WEST
Practice Address - Street 2:STE 201
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4090
Practice Address - Country:US
Practice Address - Phone:661-726-5005
Practice Address - Fax:661-726-5377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19060OtherMEDICARE PROV #
CA00AX89540OtherMEDI-CAL
CA020A89450OtherBS OF CA
CADD9185OtherRR MEDICARE
CA00AX89540OtherMEDI-CAL