Basic Information
| Provider Information | |||||||||
| NPI: | 1366655532 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AHUJA | ||||||||
| FirstName: | ANITA | ||||||||
| MiddleName: | T. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 275 W MACARTHUR BLVD | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946115641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107521000 | ||||||||
| FaxNumber: | 5107526849 | ||||||||
| Practice Location | |||||||||
| Address1: | 275 W MACARTHUR BLVD | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946115641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107521000 | ||||||||
| FaxNumber: | 5107526849 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2007 | ||||||||
| LastUpdateDate: | 12/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | A92045 | CA | Y | Other Service Providers | Specialist |
No ID Information.