MEDICARE: ANITHA ANGAN 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	207RP1001X	Pulmonary Disease Physician	A94004	CA

General Provider Information

NPI Number	:	1528261500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITHA ANGAN MD

Provider Business Mailing Address
First Line	:	5401 NORRIS CANYON RD
Second Line	:	STE 308
City	:	SAN RAMON
State	:	CA
Zip	:	94583-5408
Country	:	US
Telephone Number	:	925-866-8822
Fax Number	:	925-866-8323

Provider Business Practice Location Address
First Line	:	5401 NORRIS CANYON RD
Second Line	:	STE 308
City	:	SAN RAMON
State	:	CA
Zip	:	94583-5408
Country	:	US
Telephone Number	:	925-866-8822
Fax Number	:	925-866-8323

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

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	02/11/2020

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