Provider Demographics
NPI:1932253861
Name:FATIMA, ANEES (MD)
Entity Type:Individual
Prefix:
First Name:ANEES
Middle Name:
Last Name:FATIMA
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 1:1076 S TAYLOR CT
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-2425
Mailing Address - Country:US
Mailing Address - Phone:714-281-7221
Mailing Address - Fax:714-281-7221
Practice Address - Street 1:8825 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660
Practice Address - Country:US
Practice Address - Phone:562-699-3333
Practice Address - Fax:562-699-7009
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51813261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF74468Medicare UPIN