Provider Demographics
NPI:1356923023
Name:SUSHIL ANAND & ASSOCIATES MEDICAL CORP
Entity type:Organization
Organization Name:SUSHIL ANAND & ASSOCIATES MEDICAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-795-7051
Mailing Address - Street 1:800 FAIRMOUNT AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3151
Mailing Address - Country:US
Mailing Address - Phone:626-795-7051
Mailing Address - Fax:626-795-1859
Practice Address - Street 1:900 S MAIN ST STE 108
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3401
Practice Address - Country:US
Practice Address - Phone:951-734-5450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1548444250OtherNPI
CA1548444250Medicaid