Organization
ANANIAS E. EBILANE, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANANIAS ELACION EBILANE M.D. (PHYSICIAN)
(310) 644-8683
Entity
Organization
Contact information
Practice address
13429 S HAWTHORNE BLVD, HAWTHORNE, CA 90250-5803
(310) 644-8683
(310) 644-0132
Mailing address
13429 S HAWTHORNE BLVD, HAWTHORNE, CA 90250-5803
(310) 644-8683
(310) 644-0132
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A340210
—
CA
01
—
W21701
MEDICARE PTAN
—
Enumeration date
08/10/2006
Last updated
03/27/2008
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