| Ananias E. Ebilane, M.d., Inc | |
|
13429 S Hawthorne Blvd Hawthorne CA 90250-5803 | |
| (310) 644-8683 | |
| (310) 644-0132 |
| Full Name | Ananias E. Ebilane, M.d., Inc |
|---|---|
| Speciality | General Practice |
| Location | 13429 S Hawthorne Blvd, Hawthorne, California |
| Authorized Official Name and Position | Ananias Elacion Ebilane (PHYSICIAN) |
| Authorized Official Contact | 3106448683 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ananias E. Ebilane, M.d., Inc 13429 S Hawthorne Blvd Hawthorne CA 90250-5803 Ph: (310) 644-8683 | Ananias E. Ebilane, M.d., Inc 13429 S Hawthorne Blvd Hawthorne CA 90250-5803 Ph: (310) 644-8683 |
| NPI Number | 1144231093 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 03/27/2008 |
| Medicare PECOS PAC ID | 9032292891 |
|---|---|
| Medicare Enrollment ID | O20080216000122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144231093 | NPI | - | NPPES |
| 00A340210 | Medicaid | CA | |
| W21701 | Other | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Ananias E Ebilane |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1265611362 PECOS PAC ID: 1153404173 Enrollment ID: I20080216000120 |
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