| Antaki & Associates Infectious Disease Medical Group Inc | |
|
801 S Chevy Chase Dr 101 Glendale CA 91205-4431 | |
| (818) 242-5299 | |
| (818) 637-7607 |
| Full Name | Antaki & Associates Infectious Disease Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 801 S Chevy Chase Dr, Glendale, California |
| Authorized Official Name and Position | Jean-peirre Antaki (OWNER) |
| Authorized Official Contact | 8182425299 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Antaki & Associates Infectious Disease Medical Group Inc 801 S Chevy Chase Dr 101 Glendale CA 91205-4431 Ph: (818) 242-5299 | Antaki & Associates Infectious Disease Medical Group Inc 801 S Chevy Chase Dr 101 Glendale CA 91205-4431 Ph: (818) 242-5299 |
| NPI Number | 1124083274 |
|---|---|
| Provider Enumeration Date | 04/20/2006 |
| Last Update Date | 02/05/2018 |
| Medicare PECOS PAC ID | 0941295943 |
|---|---|
| Medicare Enrollment ID | O20040419000963 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124083274 | NPI | - | NPPES |
| GROO93960 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (California) | Primary |
| Provider Name | Jean-pierre E Antaki |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1013972876 PECOS PAC ID: 1153316161 Enrollment ID: I20040419001017 |
| Provider Name | Arash Alborzi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1770582165 PECOS PAC ID: 9032157409 Enrollment ID: I20050418000882 |
| Provider Name | Byron K Williams |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1295790319 PECOS PAC ID: 7315063732 Enrollment ID: I20100923000114 |
| Provider Name | Carisa L Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467813345 PECOS PAC ID: 3870892797 Enrollment ID: I20160427002390 |
| Provider Name | Michelle Padilla Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104310002 PECOS PAC ID: 1254671472 Enrollment ID: I20190325001850 |
| Provider Name | Hovik Abedi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689277527 PECOS PAC ID: 7618347253 Enrollment ID: I20221223000557 |
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