Provider Demographics
NPI:1780795963
Name:ANILE, PAUL ANGELO (DO)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ANGELO
Last Name:ANILE
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 1:107 BAY SHORE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-3449
Mailing Address - Country:US
Mailing Address - Phone:562-230-7285
Mailing Address - Fax:562-438-5383
Practice Address - Street 1:3851 S SOTO ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CA
Practice Address - Zip Code:90058-1718
Practice Address - Country:US
Practice Address - Phone:323-585-7162
Practice Address - Fax:323-585-0167
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2OA61102083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine