Provider Demographics
NPI:1255539946
Name:DAI, ANITA D (MD)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:D
Last Name:DAI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1909 E RAY RD
Mailing Address - Street 2:STE 9-154
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8735
Mailing Address - Country:US
Mailing Address - Phone:480-888-5421
Mailing Address - Fax:855-847-8908
Practice Address - Street 1:10404 W COGGINS DR
Practice Address - Street 2:STE 118
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3465
Practice Address - Country:US
Practice Address - Phone:623-972-1055
Practice Address - Fax:623-972-1185
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2015-07-01
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Provider Licenses
StateLicense IDTaxonomies
AZ37198207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ37198OtherMEDICAL LICENSE
AZ228405Medicaid
AZ228405Medicaid
AZ120622Medicare UPIN