Healthcare Provider Details

I. General information

NPI: 1679478804
Provider Name (Legal Business Name): ANUCHEAT CHEA MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4340 REDWOOD HWY
SAN RAFAEL CA
94903-2121
US

IV. Provider business mailing address

4340 REDWOOD HWY
SAN RAFAEL CA
94903-2121
US

V. Phone/Fax

Practice location:
  • Phone: 415-472-2343
  • Fax: 415-472-2343
Mailing address:
  • Phone: 415-472-2343
  • Fax: 415-472-2343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: PATRICIA HERMAN
Title or Position: INSURANCE SPECIALIST
Credential:
Phone: 415-472-2343