Healthcare Provider Details

I. General information

NPI: 1942256060
Provider Name (Legal Business Name): ANU CHIRALA A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 10/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18511 MISSION VIEW DR SUITE 120
MORGAN HILL CA
95037-2974
US

IV. Provider business mailing address

18511 MISSION VIEW DR SUITE 120
MORGAN HILL CA
95037-2974
US

V. Phone/Fax

Practice location:
  • Phone: 408-779-9422
  • Fax: 408-779-4113
Mailing address:
  • Phone: 408-779-9422
  • Fax: 408-779-4113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA55594
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number7322-43
License Number StateCA

VIII. Authorized Official

Name: DR. ANU CHIRALA
Title or Position: CARDIOLOGIST
Credential: M.D., F.A.C.C.
Phone: 408-779-9422