Provider Demographics
NPI:1669867032
Name:KAYALOGLOU, ANNA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:ANNA MARIA
Middle Name:
Last Name:KAYALOGLOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39000 BOB HOPE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3221
Mailing Address - Country:US
Mailing Address - Phone:760-340-3911
Mailing Address - Fax:
Practice Address - Street 1:45280 SEELEY DR
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-6834
Practice Address - Country:US
Practice Address - Phone:760-834-3593
Practice Address - Fax:760-564-0101
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA156326207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine