Provider Demographics
NPI:1467424309
Name:PAI, ANITA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:M
Last Name:PAI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6800 BROCKTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3835
Mailing Address - Country:US
Mailing Address - Phone:909-557-1600
Mailing Address - Fax:909-557-1740
Practice Address - Street 1:6800 BROCKTON AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3810
Practice Address - Country:US
Practice Address - Phone:915-683-0650
Practice Address - Fax:915-774-4617
Is Sole Proprietor?:No
Enumeration Date:2006-02-05
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA74144208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A741441Medicare PIN