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General NPI Number Information
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NPI Number | 1912872243
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Entity Type | Individual
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Provider Name | SHAHRUKH ANWER
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Gender | Male
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Dates
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Enumeration Date | 10/07/2025
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 901 E ALOSTA AVE
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City | AZUSA
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State | CA
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Zip | 91702-2701
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Country | US
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Telephone | 626-969-3434
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Fax |
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Provider Business Mailing Address
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Address Line | 7928 PHLOX ST
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City | DOWNEY
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State | CA
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Zip | 90241-4506
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Country | US
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Telephone | 530-788-5618
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95035673
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License Number State | CA
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