Healthcare Provider Details

I. General information

NPI: 1114944824
Provider Name (Legal Business Name): ANOOP MAHESHWARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1157 W GRAND BLVD
CORONA CA
92882
US

IV. Provider business mailing address

1157 W GRAND BLVD
CORONA CA
92882-4364
US

V. Phone/Fax

Practice location:
  • Phone: 951-737-5809
  • Fax: 951-848-6923
Mailing address:
  • Phone: 951-737-5809
  • Fax: 951-848-6923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA045841
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA45841
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: