Healthcare Provider Details

I. General information

NPI: 1649584426
Provider Name (Legal Business Name): MEENA TANWAR-AHUJA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEENA KUMARI TANWAR-AHUJA MD

II. Dates (important events)

Enumeration Date: 08/04/2010
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 CORPORATE DR STE 200
LADERA RANCH CA
92694-2179
US

IV. Provider business mailing address

24422 AVENIDA DE LA CARLOTA STE 300
LAGUNA HILLS CA
92653-3628
US

V. Phone/Fax

Practice location:
  • Phone: 949-347-7200
  • Fax:
Mailing address:
  • Phone: 949-599-2434
  • Fax: 949-599-2430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR71718
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA129156
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: