MEDICARE: ANU GARG 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	208D00000X	General Practice Physician	273439	NY
2	208000000X	Pediatrics Physician	273439	NY

General Provider Information

NPI Number	:	1548500259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANU GARG MD

Provider Business Mailing Address
First Line	:	1311 N SAN FERNANDO BLVD
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-4236
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1311 N SAN FERNANDO BLVD
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504
Country	:	US
Telephone Number	:	818-843-9900
Fax Number	:

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

Provider Enumeration Date	:	02/18/2013
Last Update Date	:	02/22/2019

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