Basic Information
| Provider Information | |||||||||
| NPI: | 1033500780 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANTHIS | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | CRISTIAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2999 WESTMINSTER AVE STE 104 | ||||||||
| Address2: | |||||||||
| City: | SEAL BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907405389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624314314 | ||||||||
| FaxNumber: | 5624314305 | ||||||||
| Practice Location | |||||||||
| Address1: | 2999 WESTMINSTER AVE STE 104 | ||||||||
| Address2: | |||||||||
| City: | SEAL BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907405389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624314314 | ||||||||
| FaxNumber: | 5624314305 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2015 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | 7730 | CA | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.