MEDICARE: DR. AMAR ANAND MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TB0200X	Cognitive & Behavioral Psychologist	01080969A	IN
2	2084D0003X	Diagnostic Neuroimaging (Psychiatry & Neurology) Physician	A149857	CA
3	2084N0400X	Neurology Physician	01080969A	IN
4	2084N0400X	Neurology Physician	LL36095	SC
5	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	A149857	CA
6	2084N0400X	Neurology Physician	A149857	CA

General Provider Information

NPI Number	:	1407297005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMAR ANAND MD

Provider Business Mailing Address
First Line	:	712 BANCROFT RD STE 905
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94598-1531
Country	:	US
Telephone Number	:	707-980-6257
Fax Number	:	707-980-6692

Provider Business Practice Location Address
First Line	:	155 GLEN COVE MARINA RD E
Second Line	:
City	:	VALLEJO
State	:	CA
Zip	:	94591-7284
Country	:	US
Telephone Number	:	707-980-6257
Fax Number	:	707-980-6692

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2013
Last Update Date	:	10/15/2020

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Directions to “ DR. AMAR ANAND MD” Practice Location

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