Provider Demographics
NPI:1154422798
Name:ANASCO, MEGAN H (OD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:H
Last Name:ANASCO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0302
Practice Address - Country:US
Practice Address - Phone:916-536-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11066T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA098992OtherHEALTH NET
CA90813OtherINTERPLAN
CA000810618284OtherPHCS
CA2011025OtherGREAT WEST
CA10066TOtherBLUE CROSS
CA90132914OtherPACIFICARE
CA7245191OtherAETNA
CAMCMG239000OtherWESTERN HEALTH ADVANTAGE
CASD0110660Medicaid
CA90132914OtherPACIFICARE
CA2011025OtherGREAT WEST