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Individual

DR. ADELAIDA B ANTONIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
21001 SHERMAN WAY, SUITE 15, CANOGA PARK, CA 91303-1760
(818) 716-0048
(818) 785-3330
Mailing address
21001 SHERMAN WAY, SUITE 15, CANOGA PARK, CA 91303-1760
(818) 716-0048
(818) 785-3330

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
C41801
CA
208D00000X
General Practice Physician
Primary
C41801
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00C418010
CA
Enumeration date
05/17/2007
Last updated
12/11/2011
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