Provider Demographics
NPI:1164679908
Name:YALOM, ANISA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANISA
Middle Name:M
Last Name:YALOM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:277 RANCHEROS DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2976
Mailing Address - Country:US
Mailing Address - Phone:760-750-1902
Mailing Address - Fax:760-635-7801
Practice Address - Street 1:277 RANCHEROS DR STE 101
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-2976
Practice Address - Country:US
Practice Address - Phone:760-750-1902
Practice Address - Fax:760-635-7801
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1099912086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty