Provider Demographics
NPI:1497842090
Name:MOLANI, MUHAMMAD ANWAR (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:ANWAR
Last Name:MOLANI
Suffix:
Gender:M
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:PO BOX 29472
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-7472
Mailing Address - Country:US
Mailing Address - Phone:818-998-1578
Mailing Address - Fax:818-998-1578
Practice Address - Street 1:16237 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2201
Practice Address - Country:US
Practice Address - Phone:818-995-5231
Practice Address - Fax:818-995-5397
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12708R207ZP0102X
CAC53899207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA174358900OtherLA WORKERS COMP
LA12708ROtherLA - LICENSE
CAC53899OtherCALIFORNIA LICENSE
LA1565989Medicaid
CADQ7083OtherMEDICARE RAILROAD CARRIER
CA6962639OtherMEDI-CAL
LA5H195Medicare PIN
LA174358900OtherLA WORKERS COMP