Anita J Prabhu, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A70639 Issued in CA

Practice address

1524 McHenry Ave
3Rd Floor
Modesto, CA 95350-4500

Phone

(209) 557-6200

Fax

(209) 557-6239

NPI assigned

Jul 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851312060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE",
            "address_2": "3RD FLOOR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504500",
            "telephone_number": "209-557-6200",
            "fax_number": "209-557-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE",
            "address_2": "3RD FLOOR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504500",
            "telephone_number": "209-557-6200",
            "fax_number": "209-557-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHU",
        "first_name": "ANITA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A70639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhyann Power
• Anna Powers
• Sean Powers
• Stephanie Ann Powers
• Marissa S Poyorena
• Mia Kimberly Prado-Delgado
• Erica Angelina Prado-Diaz, MA
• Isabel Janell Prado-Torres
• Alex Misael Prado
• Kassandra Prado

• Internal Medicine Physician in Modesto, CA
• Providers in Modesto, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.