Provider Demographics
NPI:1366476624
Name:BAJPAI, ANITA (MD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:BAJPAI
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 1:355 PLACENTIA AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3301
Mailing Address - Country:US
Mailing Address - Phone:949-574-1091
Mailing Address - Fax:949-262-0700
Practice Address - Street 1:355 PLACENTIA AVE STE 102
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3301
Practice Address - Country:US
Practice Address - Phone:949-574-1091
Practice Address - Fax:949-574-1097
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78368207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A783680Medicaid
CAWA78368AMedicare PIN
CAH87885Medicare UPIN
CA00A783680Medicaid