Provider Demographics
NPI:1225164056
Name:REPRODUCTIVE HEALTH CARE CENTER
Entity Type:Organization
Organization Name:REPRODUCTIVE HEALTH CARE CENTER
Other - Org Name:SIERRA HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-526-5770
Mailing Address - Street 1:1801 TULLY RD STE F
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-2931
Mailing Address - Country:US
Mailing Address - Phone:209-526-5770
Mailing Address - Fax:209-544-1234
Practice Address - Street 1:1801 TULLY RD STE F
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-2931
Practice Address - Country:US
Practice Address - Phone:209-526-5770
Practice Address - Fax:209-544-1234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFNP336825OtherDEE SCHLANDER, FNP
CAPA13310OtherLOREN BAUMAN, PA
CAA31978OtherMICHAEL BRODIE, MD
CADO 20A6338OtherLISA HUNT, DO
CAA17110OtherSAMUEL CHAMPAIGN, MD
CAC41165OtherSIVARAMA MADIREDDI, MD
CA00A319780Medicaid
OHG28039OtherPHILLIP KALMAN, MD
CANP12281OtherGLORIA BENNETT, NP
CADO 20A6338OtherLISA HUNT, DO
CA00A171102Medicare ID - Type UnspecifiedSAMUEL CHAMPAIGN, MD
CAC41165OtherSIVARAMA MADIREDDI, MD
CAA17110OtherSAMUEL CHAMPAIGN, MD
CAP52559Medicare UPIN
CA22310162Medicare ID - Type UnspecifiedGLORIA BENNETT, NP
CA00A319780Medicaid