MEDICARE: ANITA M. PAI, M.D. INC

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	208100000X	Physical Medicine & Rehabilitation Physician	A74144	CA

General Provider Information

NPI Number	:	1952336075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANITA M. PAI, M.D. INC

Provider Business Mailing Address
First Line	:	1533 SERPENTINE DR
Second Line	:
City	:	REDLANDS
State	:	CA
Zip	:	92373-6558
Country	:	US
Telephone Number	:	909-953-0409
Fax Number	:

Provider Business Practice Location Address
First Line	:	6800 BROCKTON AVE
Second Line	:	STE 2
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-3810
Country	:	US
Telephone Number	:	951-683-0650
Fax Number	:	915-774-4617

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANITA M PAI
Credential	:	M.D.
Telephone Number	:	909-953-0409

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	04/05/2012

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