Organization
ANITA SIVASUBRAMANIAN M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA SIVASUBRAMANIAN M.D. (OWNER)
(559) 360-9589
Entity
Organization
Contact information
Practice address
7035 N CHESTNUT AVE STE 105, FRESNO, CA 93720-0352
(559) 353-2300
(559) 353-2323
Mailing address
7035 N CHESTNUT AVE STE 105, FRESNO, CA 93720-0352
(559) 353-2300
(559) 353-2323
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A74387
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A743870
—
CA
01
—
CB885A
MEDICARE PTAN
CA
Enumeration date
06/23/2009
Last updated
01/28/2020
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