Provider Demographics
NPI:1285906693
Name:LEDONNE, ANTHONY T (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:T
Last Name:LEDONNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CORTE VIZCAYA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-6853
Mailing Address - Country:US
Mailing Address - Phone:949-369-5799
Mailing Address - Fax:
Practice Address - Street 1:16 CORTE VIZCAYA
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-6853
Practice Address - Country:US
Practice Address - Phone:949-369-5799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC26071207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology