Provider Demographics
NPI:1790875482
Name:SAPAN, ANAT (MD)
Entity Type:Individual
Prefix:
First Name:ANAT
Middle Name:
Last Name:SAPAN
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:PO BOX 554
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-0554
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:11135 SAN PABLO AVE
Practice Address - Street 2:POST BOX 554
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-6098
Practice Address - Country:US
Practice Address - Phone:707-816-6549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88571207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A885710Medicaid
CA00A885710Medicaid
I13232Medicare UPIN