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General NPI Number Information
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NPI Number | 1982153797
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Entity Type | Organization
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Legal Business Name | ANAS KAWAYEH MD INC
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Dates
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Enumeration Date | 09/22/2016
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 2006 N RIVERSIDE AVE STE A
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City | RIALTO
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State | CA
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Zip | 92377-4696
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Country | US
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Telephone | 909-883-2999
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Fax |
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Provider Business Mailing Address
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Address Line | 375 TERRACINA BLVD
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City | REDLANDS
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State | CA
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Zip | 92373-3801
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Country | US
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Telephone | 909-883-2999
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANAS KAWAYEH
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Credential | MD
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Telephone | 909-883-2999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A109588
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License Number State | CA
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