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General NPI Number Information
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NPI Number | 1871627463
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Entity Type | Organization
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Legal Business Name | EMIL A ANAYA MD, INC. A MEDICAL CORPORATION
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 09/18/2009
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Provider Practice Location Address
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Address Line | 105 N BASCOM AVE SUITE 104
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City | SAN JOSE
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State | CA
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Zip | 95128-1811
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Country | US
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Telephone | 408-258-8760
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Fax | 408-258-8760
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Provider Business Mailing Address
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Address Line | PO BOX 3133
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City | SAN JOSE
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State | CA
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Zip | 95156-3133
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Country | US
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Telephone | 408-258-8760
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Fax | 408-258-3645
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. EMIL ALBERTO ANAYA
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Credential | M.D.
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Telephone | 408-258-8760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | A25810
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License Number State | CA
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