Provider Demographics
NPI:1528261500
Name:ANGAN, ANITHA (MD)
Entity type:Individual
Prefix:
First Name:ANITHA
Middle Name:
Last Name:ANGAN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:5401 NORRIS CANYON RD
Mailing Address - Street 2:STE 308
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-5408
Mailing Address - Country:US
Mailing Address - Phone:925-866-8822
Mailing Address - Fax:925-866-8323
Practice Address - Street 1:5401 NORRIS CANYON RD
Practice Address - Street 2:STE 308
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-5408
Practice Address - Country:US
Practice Address - Phone:925-866-8822
Practice Address - Fax:925-866-8323
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2020-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA94004207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A940041Medicare PIN