Individual
ANITA MICHELLE GORWARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
901 WILSHIRE BLVD FL 3, SANTA MONICA, CA 90401-1854
(310) 829-8903
(424) 212-5933
Mailing address
2020 SANTA MONICA BLVD STE 300, SANTA MONICA, CA 90404-2013
(310) 582-7313
(310) 315-6118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A74221
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W14560
GROUP PTAN
CA
01
—
W14560A
GROUP PTAN
CA
01
—
W14560B
GROUP PTAN
CA
01
—
W14560C
GROUP PTAN
CA
01
—
W14560D
GROUP PTAN
CA
Enumeration date
10/25/2006
Last updated
03/24/2022
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