Healthcare Provider Details

I. General information

NPI: 1609590355
Provider Name (Legal Business Name): AANCHAL SHAHANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2022
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8640 VAN NUYS BLVD
PANORAMA CITY CA
91402-2913
US

IV. Provider business mailing address

381 HILLSDALE AVE
SANTA CLARA CA
95051-6309
US

V. Phone/Fax

Practice location:
  • Phone: 818-894-8080
  • Fax: 818-920-9957
Mailing address:
  • Phone: 408-705-7053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA62173
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: