Healthcare Provider Details

I. General information

NPI: 1932587151
Provider Name (Legal Business Name): ANANDA KALEVAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2015
Last Update Date: 11/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 BUSH STREET WEST COAST RETINA MEDICAL GROUP
SAN FRANCISCO CA
94109
US

IV. Provider business mailing address

1445 BUSH STREET
SAN FRANCISCO CA
94109
US

V. Phone/Fax

Practice location:
  • Phone: 415-972-4614
  • Fax: 415-975-0999
Mailing address:
  • Phone: 415-972-4600
  • Fax: 415-975-0999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: