Provider Demographics
NPI:1932321684
Name:ANESI, FRANK P (OD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:P
Last Name:ANESI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1192 GLENDALE GALLERIA
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91210-1301
Mailing Address - Country:US
Mailing Address - Phone:818-500-4160
Mailing Address - Fax:818-500-4162
Practice Address - Street 1:1192 GLENDALE GALLERIA
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91210-1301
Practice Address - Country:US
Practice Address - Phone:818-500-4160
Practice Address - Fax:818-500-4162
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 5240 TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0052400Medicaid
T70000Medicare UPIN
OP5240Medicare ID - Type Unspecified