Provider Demographics
NPI:1760492748
Name:MAPARA, ANUPAM M (MD)
Entity Type:Individual
Prefix:
First Name:ANUPAM
Middle Name:M
Last Name:MAPARA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3687 MT DIABLO BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3746
Mailing Address - Country:US
Mailing Address - Phone:916-854-6975
Mailing Address - Fax:
Practice Address - Street 1:3901 LONE TREE WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6200
Practice Address - Country:US
Practice Address - Phone:925-756-1192
Practice Address - Fax:925-756-1869
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA88081207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A880810Medicaid
CAA88081OtherSTATE LICENSE
CAA88081OtherSTATE LICENSE
CA00A880810Medicare PIN