Provider Demographics
NPI:1174785695
Name:VYAS, ANANT K (MD)
Entity type:Individual
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First Name:ANANT
Middle Name:K
Last Name:VYAS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1540 FLORIDA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4430
Mailing Address - Country:US
Mailing Address - Phone:209-577-5557
Mailing Address - Fax:209-579-7246
Practice Address - Street 1:1540 FLORIDA AVE STE 100
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4430
Practice Address - Country:US
Practice Address - Phone:209-577-5557
Practice Address - Fax:209-579-7246
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2021-01-18
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Provider Licenses
StateLicense IDTaxonomies
CA109332207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology