Provider Demographics
NPI:1619489242
Name:GHEYARA, ANIA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ANIA
Middle Name:
Last Name:GHEYARA
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 RICH ACRES RD
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-1618
Mailing Address - Country:US
Mailing Address - Phone:408-674-6146
Mailing Address - Fax:
Practice Address - Street 1:16 RICH ACRES RD
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-1618
Practice Address - Country:US
Practice Address - Phone:408-674-6146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-05
Last Update Date:2017-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78575207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology