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Provider Information for 1134337975

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. ADELAIDA B ANTONIO M.D.

Gender: FEMALE

Individual NPI: 1134337975

Calendar   Last Updated:  2011-12-11
  Certification Date: 

Details

Name Value
NPI 1134337975
Enumeration Date 2007-05-17
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 21001 SHERMAN WAY SUITE 15
CANOGA PARK, CA 91303-1760
United States

Phone: 818-716-0048 | Fax: 818-785-3330
View Map External Link
Primary Practice Address 21001 SHERMAN WAY SUITE 15
CANOGA PARK, CA 91303-1760
United States

Phone: 818-716-0048 | Fax: 818-785-3330
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID CA 00C418010
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 208D00000X - General Practice CA C41801
No 207Q00000X - Family Medicine CA C41801