Individual provider Active NPI

Hussam Y Antoin, MD

  • Anesthesiology Physician
  • Beverly Hills, CA
National Provider Identifier
1902894314
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A88484 Issued in CA
Practice address
120 S Spalding Dr
Ste. 301
Beverly Hills, CA 90212-1800
Phone
(310) 385-7755
NPI assigned
Oct 10, 2005
Last updated
Jan 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A88484 CA Primary

Addresses

Primary practice location

120 S Spalding Dr
Ste. 301
Beverly Hills, CA 90212-1800

Mailing address

1326 Miller Dr
Los Angeles, CA 90069-1420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051017001051 CA Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 0345266524 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A88484CAMDAnesthesiology Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1902894314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 MILLER DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900691420",
            "fax_number": "323-848-9557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S SPALDING DR",
            "address_2": "STE. 301",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902121800",
            "telephone_number": "310-385-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOIN",
        "first_name": "HUSSAM",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A88484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.