Healthcare Provider Details

I. General information

NPI: 1487774949
Provider Name (Legal Business Name): ANYA ANN TRUMLER-SEBRING M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANYA ANN JOHANSEN M.D.

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6035 FAIRVIEW RD
CHARLOTTE NC
28210-3256
US

IV. Provider business mailing address

3085 LOMA VISTA RD
VENTURA CA
93003-2916
US

V. Phone/Fax

Practice location:
  • Phone: 704-295-3000
  • Fax: 704-295-3468
Mailing address:
  • Phone: 805-648-3085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number5198
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD441152
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD0071823
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA108479
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License NumberCA108479
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2023-01008
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: