Healthcare Provider Details

I. General information

NPI: 1720949910
Provider Name (Legal Business Name): ANJALI RAI
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MOWRY AVE
FREMONT CA
94538-1716
US

IV. Provider business mailing address

2000 MOWRY AVE
FREMONT CA
94538-1716
US

V. Phone/Fax

Practice location:
  • Phone: 510-818-7200
  • Fax: 510-818-5015
Mailing address:
  • Phone: 510-818-7200
  • Fax: 510-818-5015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberPA66938
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: