Organization
ANITHA CHANNABASAVAIAH, MD INC.
Active
Organization
ANITHA CHANNABASAVAIAH, MD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITHA CHANNABASAVAIAH MD (PRESIDENT)
(209) 458-3898
Entity
Organization
Contact information
Practice address
1441 FLORIDA AVE, MODESTO, CA 95350-4404
(209) 458-3898
(209) 551-5720
Mailing address
PO BOX 576368, MODESTO, CA 95357-6368
(209) 458-3898
(209) 551-5720
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A83221
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A83221
CA
207RP1001X
Pulmonary Disease Physician
Primary
A83221
CA
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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