Organization
ANITA STINIVASA MD A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANITA SRINIVASA (OWNER/CEO)
(213) 382-2630
Entity
Organization
Contact information
Practice address
600 S LA FAYETTE PARK PL # 117, LOS ANGELES, CA 90057-3215
(213) 382-2630
(213) 382-2631
Mailing address
600 S LA FAYETTE PARK PL # 117, LOS ANGELES, CA 90057-3215
(213) 382-2630
(213) 382-2631
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A66420
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A66420
CERTIFICATE
CA
Enumeration date
07/14/2006
Last updated
08/22/2020
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