Provider Demographics
NPI:1588733166
Name:ANCHETA, NORA V (MD)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:V
Last Name:ANCHETA
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 1:2593 S KING RD
Mailing Address - Street 2:11
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122
Mailing Address - Country:US
Mailing Address - Phone:408-274-2880
Mailing Address - Fax:408-274-5166
Practice Address - Street 1:2593 S KING RD
Practice Address - Street 2:11
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122
Practice Address - Country:US
Practice Address - Phone:408-274-2880
Practice Address - Fax:408-274-5166
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30227207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A302270Medicaid
C03881Medicare UPIN
00A302270Medicare ID - Type Unspecified