Nicholas Harreld Anton, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C36268 Issued in CA

Practice address

500 Doyle Park Dr
Ste G03
Santa Rosa, CA 95405-4559

Phone

(707) 544-3411

Fax

(707) 544-0834

NPI assigned

Aug 23, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247702400000",
    "number": "1659364933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 MENDOCINO AVE",
            "address_2": "STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033634",
            "telephone_number": "707-544-3411",
            "fax_number": "707-544-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "STE G03",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054559",
            "telephone_number": "707-544-3411",
            "fax_number": "707-544-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTON",
        "first_name": "NICHOLAS",
        "middle_name": "HARRELD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2009-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C36268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "00C362680",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00410327",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C362680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Perla Anguiano
• Annadel Medical Group
• Annadel Medical Group, Inc
• Anova Education and Behavior Consultation, Inc.
• Olga Antipova
• Michele Antonelli, HEALTH COACH
• Diana E Antonio
• Marina Antonova
• Betsabe Montserrat Aparicio Medina
• Jennifer Apocotos-Kirk, RDH,MA

• Internal Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.