Provider Demographics
NPI:1902427180
Name:MAQSOOD, ANUM (MD)
Entity Type:Individual
Prefix:
First Name:ANUM
Middle Name:
Last Name:MAQSOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 PAMASSUS AVENUE
Mailing Address - Street 2:M798, BOX 0114
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-0114
Mailing Address - Country:US
Mailing Address - Phone:415-476-3891
Mailing Address - Fax:415-476-1837
Practice Address - Street 1:505 PAMASSUS AVENUE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0114
Practice Address - Country:US
Practice Address - Phone:415-476-3891
Practice Address - Fax:415-476-1837
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-29
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAPTL8165390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program