Healthcare Provider Details

I. General information

NPI: 1073723938
Provider Name (Legal Business Name): ANIL VERMA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 INTERNATIONAL BLVD
OAKLAND CA
94606-2235
US

IV. Provider business mailing address

2041 55TH AVE
OAKLAND CA
94621-4317
US

V. Phone/Fax

Practice location:
  • Phone: 510-835-2777
  • Fax:
Mailing address:
  • Phone: 510-535-2047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: