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Individual

JOHN M ANASTASATOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
436 N BEDFORD DR STE 215, BEVERLY HILLS, CA 90210-4312
(310) 888-4048
(310) 888-2827
Mailing address
436 N BEDFORD DR STE 215, BEVERLY HILLS, CA 90210-4312
(310) 888-4048
(310) 888-2827

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
22756
AL
208200000X
Plastic Surgery Physician
271451
NY
208200000X
Plastic Surgery Physician
Primary
A92907
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009932161
AL
05
009943075
AL
05
009994720
AL
01
051509016
BLUE CROSS
AL
05
051509016
AL
01
051509018
BLUE CROSS
AL
01
051519920
BLUE CROSS
AL
01
051529761
BLUE CROSS
AL
01
240007710
RAILROAD MEDICARE
AL
Enumeration date
05/23/2006
Last updated
11/13/2019
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