Provider Demographics
NPI:1770878811
Name:AVNAIM, ANTHONY (DO)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:AVNAIM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:AVNAIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:24035 NEWHALL RANCH RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5702
Mailing Address - Country:US
Mailing Address - Phone:661-291-3444
Mailing Address - Fax:
Practice Address - Street 1:24035 NEWHALL RANCH RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-5702
Practice Address - Country:US
Practice Address - Phone:661-291-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116023850207Q00000X
CA20A13259207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine