Provider Demographics
NPI:1922033497
Name:ADAMS, ANISE R (MD)
Entity type:Individual
Prefix:DR
First Name:ANISE
Middle Name:R
Last Name:ADAMS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:777 FLOWER ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-3015
Mailing Address - Country:US
Mailing Address - Phone:818-637-2000
Mailing Address - Fax:818-242-8761
Practice Address - Street 1:191 S BUENA VISTA ST
Practice Address - Street 2:SUITE 150
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4504
Practice Address - Country:US
Practice Address - Phone:818-295-5920
Practice Address - Fax:818-295-6965
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2008-10-14
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Provider Licenses
StateLicense IDTaxonomies
CAA91840207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA91840OtherSTATE MEDICAL LICENSE NUM
CAWA91840AMedicare PIN
I55715Medicare UPIN