Doctor Name: | ANANIAS E EBILANE |
NPI Number: | 1265611362 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A34021 |
Business Practice Address: | 13429 S Hawthorne Blvd Hawthorne, CA - 902505803 |
Business Phone Number: | 3106448683 |
Business Fax Number: | 3106440132 |
Mailing Address: | 13429 S Hawthorne Blvd, HAWTHORNE |
State: | CA |
Postal Code: | 902505803 |
Phone Number: | 3106448683 |
Fax Number: | 3106440132 |
NPI Enumeration Date: | 10/25/2007 |
NPI Last Update Date: | 03/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A34021 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |