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General NPI Number Information
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NPI Number | 1285850800
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Entity Type | Individual
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Provider Name | ANAND JETHVA
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Gender | Male
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11818 ROSECRANS AVE # A
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City | NORWALK
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State | CA
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Zip | 90650-4101
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Country | US
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Telephone | 562-462-1715
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Fax | 562-462-1731
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Provider Business Mailing Address
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Address Line | 406 S BELLA VISTA ST
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City | ANAHEIM
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State | CA
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Zip | 92804-2706
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Country | US
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Telephone | 714-767-2851
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH 50334
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License Number State | CA
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