Provider Demographics
NPI:1255302089
Name:LOTAN, ANAT (MD)
Entity Type:Individual
Prefix:
First Name:ANAT
Middle Name:
Last Name:LOTAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANAT
Other - Middle Name:
Other - Last Name:PILPOUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:751 S. BASCOM AVE
Mailing Address - Street 2:PEDIATRICS DEPARTMENT
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2604
Mailing Address - Country:US
Mailing Address - Phone:408-885-5000
Mailing Address - Fax:408-946-8691
Practice Address - Street 1:751 S. BASCOM AVE.
Practice Address - Street 2:PEDIATRICS DEPARTMENT
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2604
Practice Address - Country:US
Practice Address - Phone:408-885-5000
Practice Address - Fax:408-946-8691
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11631208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics