Provider Demographics
NPI:1750446761
Name:ANANT LODHIA MD INC
Entity Type:Organization
Organization Name:ANANT LODHIA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANANT
Authorized Official - Middle Name:
Authorized Official - Last Name:LODHIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-616-5733
Mailing Address - Street 1:PO BOX 3130
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-7407
Mailing Address - Country:US
Mailing Address - Phone:916-616-5753
Mailing Address - Fax:916-966-0213
Practice Address - Street 1:601 COURT ST STE 210
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-2163
Practice Address - Country:US
Practice Address - Phone:209-223-7784
Practice Address - Fax:209-223-7783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG35942207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0049470Medicaid
CA00G359420OtherMEDICARE INDIVIDUAL
CA00G359420OtherMEDICARE INDIVIDUAL
CAZZZ26869ZMedicare PIN