Individual
ANIL RAVI DATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27141 HIDAWAY AVE STE 106, CANYON COUNTRY, CA 91351-4135
(818) 220-5209
Mailing address
27141 HIDAWAY AVE STE 106, CANYON COUNTRY, CA 91351-4135
(612) 528-4696
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
A125970
CA
Other
Enumeration date
04/16/2012
Last updated
04/12/2023
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