Provider Demographics
NPI:1467699751
Name:ANANTH SHENOY, M.D. INC.
Entity Type:Organization
Organization Name:ANANTH SHENOY, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANANTH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHENOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-778-1400
Mailing Address - Street 1:3903 LONE TREE WAY STE 311
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6252
Mailing Address - Country:US
Mailing Address - Phone:925-778-1400
Mailing Address - Fax:
Practice Address - Street 1:3903 LONE TREE WAY STE 311
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6252
Practice Address - Country:US
Practice Address - Phone:925-778-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A37840174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty