Provider Demographics
NPI:1104970250
Name:FURMAN, ANCHEL (MD)
Entity type:Individual
Prefix:
First Name:ANCHEL
Middle Name:
Last Name:FURMAN
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:PO BOX 312
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91102-0312
Mailing Address - Country:US
Mailing Address - Phone:626-535-1772
Mailing Address - Fax:626-535-1776
Practice Address - Street 1:630 S RAYMOND AVE
Practice Address - Street 2:STE #240
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3278
Practice Address - Country:US
Practice Address - Phone:626-535-1772
Practice Address - Fax:626-535-1776
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49247207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A492470Medicaid
CAW21873OtherFMC
CAWA49247EMedicare PIN
CAW14920Medicare ID - Type UnspecifiedPASADENA
CAW14920BMedicare ID - Type UnspecifiedVERDUGO
CA14920AMedicare ID - Type UnspecifiedARCADIA
CA00A492470Medicaid