Provider Demographics
NPI:1689087322
Name:ANAND, DAKSHA MORAR
Entity Type:Individual
Prefix:
First Name:DAKSHA
Middle Name:MORAR
Last Name:ANAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20737 VENETO WAY
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-4618
Mailing Address - Country:US
Mailing Address - Phone:805-559-1890
Mailing Address - Fax:
Practice Address - Street 1:23586 CALABASAS RD STE 206
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1330
Practice Address - Country:US
Practice Address - Phone:818-224-3837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 10574174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU820ZMedicare PIN