Provider Demographics
NPI:1811011844
Name:MANCIA, ANITA SUJATA PANDIT (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:SUJATA PANDIT
Last Name:MANCIA
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 1:350 S MADISON AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-3301
Mailing Address - Country:US
Mailing Address - Phone:626-577-4074
Mailing Address - Fax:
Practice Address - Street 1:350 S MADISON AVE APT 105
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-3301
Practice Address - Country:US
Practice Address - Phone:626-577-4074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83231207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine