Provider Demographics
NPI:1710118906
Name:URSALES, ANNA LEIGH CHRISTINE ORNOPIA (MD)
Entity Type:Individual
Prefix:
First Name:ANNA LEIGH CHRISTINE
Middle Name:ORNOPIA
Last Name:URSALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNA LEIGH CHRISTINE
Other - Middle Name:
Other - Last Name:ORNOPIA URSALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11234 ANDERSON ST # MC-1516
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2804
Mailing Address - Country:US
Mailing Address - Phone:909-558-2417
Mailing Address - Fax:909-558-2417
Practice Address - Street 1:11234 ANDERSON ST # MC-1516
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-558-2417
Practice Address - Fax:909-558-2417
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUM1882207RI0200X
TXP8200207RI0200X
TXBP10042682207RI0200X
WAMD60858857207RI0200X
CAA146361207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty