Organization
ALEXIS ANVEKAR MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXIS M. D. ANVEKAR M.D. (OWNER)
(626) 795-0411
Entity
Organization
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 PROVIDER #
CA
01
—
05D1055111
CLIA LAB WAIVER #
CA
01
—
DD5323
RAILROAD PROVIDER GROUP#
CA
01
—
P00233951
RAILROAD PROVIDER PIN #
CA
Enumeration date
08/21/2006
Last updated
04/21/2026
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