Healthcare Provider Details

I. General information

NPI: 1356923023
Provider Name (Legal Business Name): SUSHIL ANAND & ASSOCIATES MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S MAIN ST STE 108
CORONA CA
92882-3401
US

IV. Provider business mailing address

800 FAIRMOUNT AVE STE 110
PASADENA CA
91105-3151
US

V. Phone/Fax

Practice location:
  • Phone: 951-734-5450
  • Fax:
Mailing address:
  • Phone: 626-795-7051
  • Fax: 626-795-1859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: SUSHIL ANAND
Title or Position: CEO
Credential: MD
Phone: 626-795-7051