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General NPI Number Information
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NPI Number | 1811476047
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Entity Type | Individual
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Provider Name | ANJANAA VIJAYANARAYANAN MD
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Gender | Female
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 185 BERRY ST STE 290
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-1773
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Country | US
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Telephone | 415-353-1667
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Fax |
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Provider Business Mailing Address
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Address Line | 2799 W. GRAND BOULEVARD HENRY FORD HOSPITAL, MEDICAL EDUCATION DEPARTMENT
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City | DETROIT
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State | MI
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Zip | 48202-2608
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Country | US
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Telephone | 313-916-7389
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 4301115006
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | A175695
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License Number State | CA
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