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General NPI Number Information
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NPI Number | 1316127947
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Entity Type | Organization
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Legal Business Name | ANIL P PUNJABI, MD, DDS, INC.
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 295 TERRACINA BLVD
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City | REDLANDS
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State | CA
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Zip | 92373-4847
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Country | US
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Telephone | 909-798-9950
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Fax |
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Provider Business Mailing Address
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Address Line | 295 TERRACINA BLVD
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City | REDLANDS
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State | CA
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Zip | 92373-4847
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Country | US
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Telephone | 909-798-9950
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANIL P PUNJABI
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Credential | M.D.,D.D.S.
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Telephone | 909-798-9950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | G85143
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number | 38217
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 38217
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | A73833
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | A73833
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | G85143
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License Number State | CA
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