Individual
ANIL JASTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6555 COYLE AVE STE 180, CARMICHAEL, CA 95608-0303
(916) 536-2408
(916) 536-2465
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11558
ND
207R00000X
Internal Medicine Physician
MD25876
OR
207RR0500X
Rheumatology Physician
Primary
C135254
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270045
—
OR
01
—
838334037
BCBS-ROSEBURG
OR
01
—
838366035
BCBS-MCMINNVILLE
OR
01
—
844477031
BCBS-GRANTS PASS
OR
01
—
858463038
BCBS-MEDFORD
OR
01
—
858464041
BCBS-SPRINGFIELD
OR
01
—
P00342100
RR MEDICARE
OR
Enumeration date
03/28/2006
Last updated
10/12/2017
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