Provider Demographics
NPI:1326599283
Name:BAWA, ANUDEEP (NP)
Entity Type:Individual
Prefix:
First Name:ANUDEEP
Middle Name:
Last Name:BAWA
Suffix:
Gender:F
Credentials:NP
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4120 N 108TH AVE
Mailing Address - Street 2:# 116
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-5773
Mailing Address - Country:US
Mailing Address - Phone:623-872-1818
Mailing Address - Fax:623-872-1819
Practice Address - Street 1:11180 WARNER AVE STE 165
Practice Address - Street 2:HEART CENTER OF ORANGE COUNTY
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7515
Practice Address - Country:US
Practice Address - Phone:714-429-5886
Practice Address - Fax:714-429-5924
Is Sole Proprietor?:No
Enumeration Date:2016-10-16
Last Update Date:2017-05-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZRN206683364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health