Provider Demographics
NPI:1043322803
Name:ANANIAS, PAUL T II (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:T
Last Name:ANANIAS
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11401 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-2015
Mailing Address - Country:US
Mailing Address - Phone:562-863-7011
Mailing Address - Fax:562-864-4560
Practice Address - Street 1:11401 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2015
Practice Address - Country:US
Practice Address - Phone:562-863-7011
Practice Address - Fax:562-864-4560
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A81802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry