Provider Demographics
NPI:1770525693
Name:MARWAHA, ANUPAM (MD)
Entity type:Individual
Prefix:DR
First Name:ANUPAM
Middle Name:
Last Name:MARWAHA
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 1:905 MELBURY CT
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6322
Mailing Address - Country:US
Mailing Address - Phone:909-798-2259
Mailing Address - Fax:909-798-2259
Practice Address - Street 1:11332 MOUNTAIN VIEW AVE
Practice Address - Street 2:SUITE NUMBER D
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3854
Practice Address - Country:US
Practice Address - Phone:909-799-5445
Practice Address - Fax:909-799-2006
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72732207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G59237Medicare UPIN
00A727320Medicare PIN