Provider Demographics
NPI:1598905978
Name:LALITHA ANANTH MD FACP INC
Entity Type:Organization
Organization Name:LALITHA ANANTH MD FACP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:LALITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANANTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACP
Authorized Official - Phone:714-549-4081
Mailing Address - Street 1:11100 WARNER AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7506
Mailing Address - Country:US
Mailing Address - Phone:714-549-4081
Mailing Address - Fax:714-434-7660
Practice Address - Street 1:11100 WARNER AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7506
Practice Address - Country:US
Practice Address - Phone:714-549-4081
Practice Address - Fax:714-434-7660
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LALITHA ANANTH MD FACP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40291207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A402910OtherMEDICAL UPIN
CAA40291OtherLICENCE