Mark Anantiyo, is a medicare enrolled "Psychiatry & Neurology - Psychiatry" in Pomona, California. His current practice location is
309 E 2nd St, Pomona, California. You can reach out to his office (for appointments etc.) via phone at
(909) 623-6111.
Mark Anantiyo is licensed to practice in California (license number PA61663) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1245958453.
Provider's Profile
Full Name | Mark Anantiyo |
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Gender | Male |
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Speciality | Psychiatry & Neurology - Psychiatry |
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Location | 309 E 2nd St, Pomona, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1245958453
- Provider Enumeration Date: 08/15/2022
- Last Update Date: 05/01/2023
Medicare PECOS Information:
- PECOS PAC ID: 6608232491
- Enrollment ID: I20230522000920
Medical Identifiers
Medical identifiers for Mark Anantiyo such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1245958453 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
2084P0800X | Psychiatry & Neurology - Psychiatry | PA61663 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mark Anantiyo is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mark Anantiyo, 7617 E Hollow Oak Rd, Anaheim, CA 92808-1426 Ph: () - | Mark Anantiyo, 309 E 2nd St, Pomona, CA 91766-1854 Ph: (909) 623-6111 |
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