1891911269 NPI number — ANILA C. THAMPY, M.D., INC.

Table of content: (NPI 1891911269)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891911269 NPI number — ANILA C. THAMPY, M.D., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANILA C. THAMPY, M.D., INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891911269
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1660 E HERNDON AVE
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93720-3359
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-437-9024
Provider Business Mailing Address Fax Number:
559-437-0431

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1660 E HERNDON AVE
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93720-3359
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-437-9024
Provider Business Practice Location Address Fax Number:
559-437-0431
Provider Enumeration Date:
04/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
THAMPY
Authorized Official First Name:
ANILA
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
559-284-6264

Provider Taxonomy Codes

  • Taxonomy code: 2080A0000X , with the licence number:  A48322 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00A483220 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 078104 . This is a "HEATHNET PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: H02560 . This is a "BLUECROSS PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZZ64423Z . This is a "BLUE SHIELD PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com