Healthcare Provider Details

I. General information

NPI: 1548444250
Provider Name (Legal Business Name): SUSHIL PRABAKARAN ANAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2007
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 E ARROW HWY STE M
UPLAND CA
91786-5525
US

IV. Provider business mailing address

1175 E ARROW HWY STE M
UPLAND CA
91786-5525
US

V. Phone/Fax

Practice location:
  • Phone: 909-481-2494
  • Fax: 909-983-9766
Mailing address:
  • Phone: 909-481-2494
  • Fax: 909-983-9766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number13978
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA110593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: