Individual
ANTHONY TRABOULSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-4671
Mailing address
11234 ANDERSON STREET, GME OFFICE WESTERLY SUITE C, LOMA LINDA, CA 92354-2804
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
105188
CA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/29/2020
Last updated
04/09/2026
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