Basic Information
| Provider Information | |||||||||
| NPI: | 1972666220 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YORK | ||||||||
| FirstName: | ANITA | ||||||||
| MiddleName: | CAROL | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 31001-1920 | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911101920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145788544 | ||||||||
| FaxNumber: | 7144494956 | ||||||||
| Practice Location | |||||||||
| Address1: | 845 W LA VETA AVE | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928683930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146392600 | ||||||||
| FaxNumber: | 7144494956 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2006 | ||||||||
| LastUpdateDate: | 03/16/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | G47957 | CA | N | Other Service Providers | Specialist | 207VX0000X | G47957 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
ID Information
| ID | Type | State | Issuer | Description | G47957 | 01 | CA | MEDICAL LICENSE | OTHER | OOG479570 | 05 | CA | MEDICAID |