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General NPI Number Information
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NPI Number | 1548444250
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Entity Type | Individual
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Provider Name | SUSHIL PRABAKARAN ANAND M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 304 W F ST
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City | ONTARIO
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State | CA
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Zip | 91762-3206
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Country | US
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Telephone | 909-983-4746
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Fax | 909-983-9766
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Provider Business Mailing Address
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Address Line | 304 W F ST
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City | ONTARIO
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State | CA
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Zip | 91762-3206
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Country | US
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Telephone | 909-983-4746
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Fax | 909-983-9766
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A110593
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 13978
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License Number State | NV
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