Healthcare Provider Details

I. General information

NPI: 1538527684
Provider Name (Legal Business Name): ANAHI MUNOZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 W. JACKMAN STREET
LANCASTER CA
93535
US

IV. Provider business mailing address

506 W. JACKMAN STREET
LANCASTER CA
93535
US

V. Phone/Fax

Practice location:
  • Phone: 661-579-8364
  • Fax:
Mailing address:
  • Phone: 661-726-2850
  • Fax: 661-726-2854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: