Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 46176 | AZ |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | A121158 | CA |
N | 2081P2900X | Pain Medicine | 46176 | AZ |
N | 2081P2900X | Pain Medicine | A121158 | CA |
NPI | 1043452196 |
---|---|
Provider Name | Dr. Anuj Prakash Daftari |
First Address | Phoenix, AZ 85023-1266 |
Second Address | Gilbert, AZ 85297-0423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2009 |
Last Update Date | 17/03/2018 |