Healthcare Provider Details

I. General information

NPI: 1376448688
Provider Name (Legal Business Name): CARE CREW MANAGEMENT P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 S BROOKHURST ST
ANAHEIM CA
92804-2448
US

IV. Provider business mailing address

512 S BROOKHURST ST
ANAHEIM CA
92804-2448
US

V. Phone/Fax

Practice location:
  • Phone: 507-517-5808
  • Fax:
Mailing address:
  • Phone: 507-517-5808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANAS ANWAR AL THAHABI
Title or Position: OFFICER
Credential:
Phone: 507-517-5808