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Organization

PRAVIN J KANSAGRA MD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PRAVIN J KANSAGRA, MD MD (OWNER)
(714) 335-8570
Entity
Organization

Contact information

Practice address
1020 S ANAHEIM BLVD, SUITE 215, ANAHEIM, CA 92805-5851
(714) 335-8570
(714) 280-0128
Mailing address
1092 S TAYLOR CT, ANAHEIM, CA 92808-2425
(714) 335-8570
(714) 280-0128

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A44685
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A446850
BLUE SHIELD
CA
05
00A446850
CA
01
060111
MANAGED HEALTH NETWORK
01
1021522
CIGNA
CA
01
22139
WINDSTONE
CA
01
284863
VALUEOPTIONS
01
4584291
AETNA
01
546651409
PACIFICARE
CA
01
546651409 02
PACIFICARE BEHAVIORAL HEALTH
CA
01
796687000
MAGELLAN
Enumeration date
07/21/2010
Last updated
08/30/2010
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