# ANTHONY FENISON, MD, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ANTHONY FENISON, MD, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1376865964
- **Legal business name:** ANTHONY FENISON, MD, INC
- **Authorized official:** ANTHONY FENISON M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (909) 888-2210

## Contact information

- **Practice address:** 155 W HOSPITALITY LN STE 105, SAN BERNARDINO, CA 92408-3317
- **Practice address phone:** (909) 888-2210
- **Mailing address:** 2980 N BEVERLY GLEN CIR STE 100, LOS ANGELES, CA 90077-1728
- **Mailing address phone:** (310) 474-9809
- **Mailing address fax:** (888) 652-3017

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | G73330 | CA | Yes |

## Other

- **Enumeration date:** 02/23/2010
- **Last updated:** 03/01/2011