Dr Anil Date MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A125970 Issued in CA

Legal business name

DR ANIL DATE MD

Practice address

11550 Indian Hills Rd Ste 350
Mission Hills, CA 91345-1252

Phone

(818) 365-6632

NPI assigned

Nov 29, 2017

Last updated

Nov 29, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anil Date, MDNPI 1972860864

Title

President

Phone

(818) 365-6632

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anil Ravi Date, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Canyon Country, CA
  • NPI 1972860864
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511913600000",
    "number": "1912411885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25050 AVENUE KEARNY STE 208",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913551257",
            "telephone_number": "661-430-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 INDIAN HILLS RD STE 350",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451252",
            "telephone_number": "818-365-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR ANIL DATE MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-29",
        "last_updated": "2017-11-29",
        "status": "A",
        "authorized_official_last_name": "DATE",
        "authorized_official_first_name": "ANIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-365-6632",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A125970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A125970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanaz Dibagohar, PHARM. D.
• Peter A. Dicapua, CRNA
• Dignity Assisted Living LLC
• Diligent Care Inc (mission hills medical supply)
• Doulas for Mamas LLC
• Dr. Marc S. Thall Optometry, Inc
• Dr. Nagar Medical Psychology Center Inc
• Danny Ali Dursun, M.D.
• Jack H. Dym, MD
• Dynamic Transportation and Services

• Family Medicine Physician in Mission Hills, CA
• Providers in Mission Hills, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.