Healthcare Provider Details

I. General information

NPI: 1083841027
Provider Name (Legal Business Name): ANUJ CHAWLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2009
Last Update Date: 09/22/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 STOCKDALE HWY STE 108
BAKERSFIELD CA
93311-3621
US

IV. Provider business mailing address

100 E CALIFORNIA BLVD
PASADENA CA
91105-3205
US

V. Phone/Fax

Practice location:
  • Phone: 661-663-8500
  • Fax: 661-663-8688
Mailing address:
  • Phone: 626-568-8838
  • Fax: 626-574-7188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA136993
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: