Provider Demographics
NPI:1962474247
Name:DEBEUS, ANTHONY M (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:M
Last Name:DEBEUS
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 1:2446 W WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-3041
Mailing Address - Country:US
Mailing Address - Phone:323-728-5500
Mailing Address - Fax:
Practice Address - Street 1:2446 W WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3041
Practice Address - Country:US
Practice Address - Phone:626-831-8770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28334207W00000X, 207WX0107X
CAG84475207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZG67761Medicare UPIN
AZZ103031Medicare PIN
AZZ103032Medicare PIN
AZZ103029Medicare PIN
AZZ103030Medicare PIN
AZZ103033Medicare PIN