Active NPI
Anagha Pathak
- Contractor
- Clovis, CA
National Provider Identifier
1114041795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 5501012828
- Practice address
- 776 W Siena LN
Clovis, CA 93619 - Phone
- (352) 327-2633
- Fax
- (352) 327-2633
- NPI assigned
- Mar 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 5501012828 | MI | Primary |
Addresses
Primary practice location
776 W Siena LN
Clovis, CA 93619
Mailing address
776 W Siena LN
Clovis, CA 93619
Phone (352) 327-2633
Other names 1
- Anagha Pathak
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501012828 | MI | MD | Contractor |
Interoperability endpoints
- anagha.pathak.1@17371.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405036800000",
"number": "1114041795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "776 W SIENA LN",
"city": "CLOVIS",
"state": "CA",
"postal_code": "93619",
"telephone_number": "352-327-2633",
"fax_number": "352-327-2633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "776 W SIENA LN",
"city": "CLOVIS",
"state": "CA",
"postal_code": "93619",
"telephone_number": "352-327-2633",
"fax_number": "352-327-2633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATHAK",
"first_name": "ANAGHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2014-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "MI",
"license": "5501012828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANAGHA",
"last_name": "PATHAK",
"credential": "PT",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.