Provider Demographics
NPI:1225566656
Name:MUTHIAH, ANIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIKA
Middle Name:
Last Name:MUTHIAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 STONY BROOK CT
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-1834
Mailing Address - Country:US
Mailing Address - Phone:818-800-9273
Mailing Address - Fax:
Practice Address - Street 1:1039 STONY BROOK CT
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-1834
Practice Address - Country:US
Practice Address - Phone:818-800-9273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA165274207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty