=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811831605
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANANDA PRASAD ANANDA MD INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/14/2026
-----------------------------------------------------
Last Update Date | 04/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11224 WATSON DR
-----------------------------------------------------
City | MOORPARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93021-8750
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-268-6144
-----------------------------------------------------
Fax | 805-553-9066
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11224 WATSON DR
-----------------------------------------------------
City | MOORPARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93021-8750
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-268-6144
-----------------------------------------------------
Fax | 805-553-9066
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ANABDA PRASAD ANANDA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 805-268-6144
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------