Family Health Centre Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A93866 Issued in CA

Legal business name

FAMILY HEALTH CENTRE MEDICAL GROUP

Practice address

686 W Line St
Bishop, CA 93514-3315

Phone

(760) 872-4311

Fax

(760) 872-4130

NPI assigned

May 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Vasuki Sue Sittampalam, M.D.

Title

Owner

Phone

(760) 872-4311

Specialties & licenses 3

Addresses

Other identifiers 5

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1245280718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 W LINE ST",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935143315",
            "telephone_number": "760-872-4311",
            "fax_number": "760-872-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 W LINE ST",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935143315",
            "telephone_number": "760-872-4311",
            "fax_number": "760-872-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTRE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "SITTAMPALAM",
        "authorized_official_first_name": "VASUKI",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-872-4311",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C371720",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A93866",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "Y201575",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002086560",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53941F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0021672",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST OF WA DEPT LABOR INDUS",
            "identifier": "0205422",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "183283900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex DS Ellis, MFT
• Emery Joseph Duncan DDS Apc
• Paulette Erwin
• Jayme Leigh Everhart, FNP-C
• F W Carter & Eric I Richman PTR Dr Carter Dr Richman Optometry
• Family Health Centre Medical Group Inc
• Natalie L Feeney, COUNSELOR TRAINEE
• Leann Fields
• Jennifer Figueroa, PA
• Wendy Lee Fogelstrom, RN

• Internal Medicine Physician in Bishop, CA
• Providers in Bishop, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.