Individual
DR. ALEXIS M. D. ANVEKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
445 S FAIR OAKS AVE, PASADENA, CA 91105-2632
(626) 795-0411
(626) 795-0080
Mailing address
445 S FAIR OAKS AVE, PASADENA, CA 91105-2632
(626) 795-0411
(626) 795-0080
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A70655
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A706550
BLUE SHIELD PROV. #
CA
01
—
05D1055111
CLIA LAB WAIVER #
CA
01
—
DD5323
RAILROAD GROUP #
CA
01
—
P00233951
RAILROAD PROVIDER PIN #
CA
Enumeration date
08/21/2006
Last updated
04/21/2026
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