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General NPI Number Information
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NPI Number | 1548572589
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Entity Type | Individual
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Provider Name | ANITA MOGHE PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/07/2010
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 2800 EISENHOWER AVE STE 220
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City | ALEXANDRIA
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State | VA
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Zip | 22314-4587
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Country | US
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Telephone | 415-840-0560
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Fax |
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Provider Business Mailing Address
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Address Line | 333 1ST ST STE A
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City | SAN FRANCISCO
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State | CA
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Zip | 94105-2661
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Country | US
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Telephone | 415-840-0560
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Fax | 757-232-8875
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 02041
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA193360
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110007281
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License Number State | VA
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