Provider Demographics
NPI:1215438726
Name:MORGAN, ANTHONY WILLIAM
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:WILLIAM
Last Name:MORGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21842 MALDEN ST
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-2521
Mailing Address - Country:US
Mailing Address - Phone:818-427-0042
Mailing Address - Fax:
Practice Address - Street 1:6300 WILSHIRE BLVD STE 950
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5210
Practice Address - Country:US
Practice Address - Phone:323-866-2555
Practice Address - Fax:323-866-2560
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC26394222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist