Provider Demographics
NPI:1063439974
Name:SANGHA, ANOOP P (MD)
Entity type:Individual
Prefix:
First Name:ANOOP
Middle Name:P
Last Name:SANGHA
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 1:8949 S KINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-3016
Mailing Address - Country:US
Mailing Address - Phone:918-813-7560
Mailing Address - Fax:
Practice Address - Street 1:8949 S KINGSTON AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-3016
Practice Address - Country:US
Practice Address - Phone:918-813-7560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2012-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95928207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A959280Medicaid
CA00A959280Medicaid
H87441Medicare UPIN