Provider Demographics
NPI:1962548537
Name:ANKER, LARS (MD)
Entity type:Individual
Prefix:
First Name:LARS
Middle Name:
Last Name:ANKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1310 W STEWART DR
Mailing Address - Street 2:STE 212
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3837
Mailing Address - Country:US
Mailing Address - Phone:714-835-2724
Mailing Address - Fax:714-835-2751
Practice Address - Street 1:1310 W STEWART DR
Practice Address - Street 2:STE 212
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3837
Practice Address - Country:US
Practice Address - Phone:714-835-2724
Practice Address - Fax:714-835-2751
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA90065207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00900650Medicaid
CAWA90065AMedicare ID - Type Unspecified
CA00900650Medicaid