Provider Demographics
NPI:1396935250
Name:ANCHETA, JANICE CASAMINA (MD)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:CASAMINA
Last Name:ANCHETA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:APRIL
Other - Last Name:CASAMINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2910
Mailing Address - Street 2:DEPARTMENT OF RADIOLOGY, BOX 27
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90509-2910
Mailing Address - Country:US
Mailing Address - Phone:310-222-2847
Mailing Address - Fax:310-618-9500
Practice Address - Street 1:1000 W CARSON ST
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY, BOX 27
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:310-222-2847
Practice Address - Fax:310-618-9500
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94525390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program