Provider Demographics
NPI:1720137680
Name:ANANTANI, SANDEEP P (RPH)
Entity Type:Individual
Prefix:
First Name:SANDEEP
Middle Name:P
Last Name:ANANTANI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4809
Mailing Address - Country:US
Mailing Address - Phone:805-922-1979
Mailing Address - Fax:805-928-0713
Practice Address - Street 1:1430 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4809
Practice Address - Country:US
Practice Address - Phone:805-922-1979
Practice Address - Fax:805-928-0713
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA457391835G0303X, 1835P1200X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Not Answered1835X0200XPharmacy Service ProvidersPharmacistOncology