Provider Demographics
NPI:1457821225
Name:DANEWALIA, ANOOP SINGH
Entity Type:Individual
Prefix:
First Name:ANOOP
Middle Name:SINGH
Last Name:DANEWALIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3227 S TIPTON ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-4443
Mailing Address - Country:US
Mailing Address - Phone:559-802-0390
Mailing Address - Fax:
Practice Address - Street 1:3227 S TIPTON ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-4443
Practice Address - Country:US
Practice Address - Phone:559-802-0390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79529183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist