Anitha Channabasavaiah, MD Inc.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

A83221 Issued in CA

Legal business name

ANITHA CHANNABASAVAIAH, MD INC.

Practice address

1441 Florida Ave
Modesto, CA 95350-4404

Phone

(209) 458-3898

Fax

(209) 551-5720

NPI assigned

Apr 21, 2011

Organization subpart

No

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

Authorized official

Name

Anitha Channabasavaiah, MD

Title

President

Phone

(209) 458-3898

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303344000000",
    "number": "1730470022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576368",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953576368",
            "telephone_number": "209-458-3898",
            "fax_number": "209-551-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504404",
            "telephone_number": "209-458-3898",
            "fax_number": "209-551-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANITHA CHANNABASAVAIAH, MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-21",
        "last_updated": "2011-04-21",
        "status": "A",
        "authorized_official_last_name": "CHANNABASAVAIAH",
        "authorized_official_first_name": "ANITHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-458-3898",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A83221",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A83221",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A83221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pulmonary Disease Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.