Provider Demographics
NPI:1649328717
Name:ANCKER, MEGAN L (MD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:L
Last Name:ANCKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 STANLEY WAY
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-2914
Mailing Address - Country:US
Mailing Address - Phone:415-321-8833
Mailing Address - Fax:
Practice Address - Street 1:1241 E. HILLSDALE BLVD., 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-1296
Practice Address - Country:US
Practice Address - Phone:650-570-2299
Practice Address - Fax:650-570-5949
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48428207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G484280Medicare PIN
CAF63119Medicare UPIN