Healthcare Provider Details

I. General information

NPI: 1699302257
Provider Name (Legal Business Name): ANYA LIA EDEN REININ PLATT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 LAWRENCE EXPY
SANTA CLARA CA
95051-5173
US

IV. Provider business mailing address

710 LAWRENCE EXPY
SANTA CLARA CA
95051-5173
US

V. Phone/Fax

Practice location:
  • Phone: 669-372-6207
  • Fax:
Mailing address:
  • Phone: 669-372-6207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5343
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA184014
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: