Provider Demographics
NPI:1568438976
Name:CHARU, VEENA (MD)
Entity type:Individual
Prefix:DR
First Name:VEENA
Middle Name:
Last Name:CHARU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 W ROMNEYA DR
Mailing Address - Street 2:STE # 203
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1830
Mailing Address - Country:US
Mailing Address - Phone:714-999-1465
Mailing Address - Fax:714-999-1465
Practice Address - Street 1:1801 W ROMNEYA DR
Practice Address - Street 2:STE # 203
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1830
Practice Address - Country:US
Practice Address - Phone:714-999-1465
Practice Address - Fax:714-999-1465
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45465174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A454650Medicaid
CAA45465OtherCOMMERICAL
CAWA454650Medicare PIN
CA00A454650Medicaid