Provider Demographics
NPI:1720069438
Name:ALASTRA, ANTHONY JOHN GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOHN GERARD
Last Name:ALASTRA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2560 N HERMOSA DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-2323
Mailing Address - Country:US
Mailing Address - Phone:646-265-2770
Mailing Address - Fax:760-832-7824
Practice Address - Street 1:1080 N INDIAN CANYON DR STE 201
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4871
Practice Address - Country:US
Practice Address - Phone:760-507-8473
Practice Address - Fax:760-507-8316
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY217720-1207T00000X
NJ25MA07917400207T00000X
CAC1561324207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02584898Medicaid
I19909Medicare UPIN
NY02584898Medicaid