Basic Information
Provider Information
NPI: 1710635800
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRIKHA
FirstName: ANJAN
MiddleName:  
NamePrefix: PROF.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 383 KING ST APT 1710
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941581693
CountryCode: US
TelephoneNumber: 4154769043
FaxNumber:  
Practice Location
Address1: 521 PARNASSUS AVE DEPT OF
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941432206
CountryCode: US
TelephoneNumber: 4154769043
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/17/2022
LastUpdateDate: 03/17/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/13/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X2113CAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home