Provider Demographics
NPI:1558453258
Name:BATRA, ANJAN SINGH (MD)
Entity Type:Individual
Prefix:
First Name:ANJAN
Middle Name:SINGH
Last Name:BATRA
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 1:1140 W LA VETA AVE STE 750
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4217
Mailing Address - Country:US
Mailing Address - Phone:714-581-4401
Mailing Address - Fax:714-581-4420
Practice Address - Street 1:1140 W LA VETA AVE
Practice Address - Street 2:750
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4225
Practice Address - Country:US
Practice Address - Phone:714-581-4401
Practice Address - Fax:714-581-4420
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA618382080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A618380Medicaid
CA00A618380 851OtherCAL OPTIMA