Provider Demographics
NPI:1881081339
Name:ANTHONY, HENRY ASUTIN (NP)
Entity type:Individual
Prefix:MR
First Name:HENRY
Middle Name:ASUTIN
Last Name:ANTHONY
Suffix:
Gender:M
Credentials:NP
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2339 W CLEVELAND AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-8765
Mailing Address - Country:US
Mailing Address - Phone:559-664-4000
Mailing Address - Fax:559-675-5224
Practice Address - Street 1:2339 W CLEVELAND AVE STE 103
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-8765
Practice Address - Country:US
Practice Address - Phone:559-664-4000
Practice Address - Fax:559-675-5224
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA679628163W00000X
CA95002187363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse