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General NPI Number Information
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NPI Number | 1023542529
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Entity Type | Individual
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Provider Name | ANEESH LOPEZ-NANDAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/12/2017
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 2000 VAN NESS AVE STE 405
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-3019
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Country | US
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Telephone | 415-567-6704
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Fax | 415-567-6707
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Provider Business Mailing Address
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Address Line | 401 PARNASSUS AVE, BOX-0984
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-0984
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 157697
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License Number State | CA
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