Basic Information
Provider Information
NPI: 1689834533
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOLNAR
FirstName: ANNA
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 24310 MOULTON PKWY
Address2: SUITE O #563
City: LAGUNA HILLS
State: CA
PostalCode: 926373306
CountryCode: US
TelephoneNumber: 9496804500
FaxNumber: 9495989529
Practice Location
Address1: 31872 COAST HWY
Address2:  
City: LAGUNA BEACH
State: CA
PostalCode: 926516773
CountryCode: US
TelephoneNumber: 9494991311
FaxNumber: 9494998695
Other Information
ProviderEnumerationDate: 06/13/2008
LastUpdateDate: 06/13/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XA119161CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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