Provider Demographics
NPI:1265552830
Name:ANJUM, FARZANA
Entity type:Individual
Prefix:
First Name:FARZANA
Middle Name:
Last Name:ANJUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FARZANA
Other - Middle Name:ANJUM
Other - Last Name:ABBAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:213 DARTMOUTH WAY
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-5109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4201 W CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-1505
Practice Address - Country:US
Practice Address - Phone:714-748-6166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28186225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist