Organization
ONLINE CARE NETWORK III PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER ANTALL MD (PRESIDENT)
(617) 204-3500
Entity
Organization
Contact information
Practice address
2550 SANDYCREEK DR, WESTLAKE VILLAGE, CA 91361-5545
(617) 204-3500
Mailing address
75 STATE ST FL 26, BOSTON, MA 02109-1827
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/05/2013
Last updated
02/05/2013
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