=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386330439
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANEES MD, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2023
-----------------------------------------------------
Last Update Date | 04/13/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1566 SUNBLUFF DR
-----------------------------------------------------
City | DIAMOND BAR
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91765-3906
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-561-0625
-----------------------------------------------------
Fax | 310-943-0461
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1566 SUNBLUFF DR
-----------------------------------------------------
City | DIAMOND BAR
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91765-3906
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-561-0625
-----------------------------------------------------
Fax | 310-943-0461
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MUHAMMAD FAROOQ ANEES
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 310-561-0625
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------