Provider Demographics
NPI:1891911269
Name:ANILA C. THAMPY, M.D., INC.
Entity Type:Organization
Organization Name:ANILA C. THAMPY, M.D., INC.
Other - Org Name:SIERRA PEDIATRIC MEDICAL CENTER INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANILA
Authorized Official - Middle Name:
Authorized Official - Last Name:THAMPY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-284-6264
Mailing Address - Street 1:1660 E HERNDON AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3359
Mailing Address - Country:US
Mailing Address - Phone:559-437-9024
Mailing Address - Fax:559-437-0431
Practice Address - Street 1:1660 E HERNDON AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3359
Practice Address - Country:US
Practice Address - Phone:559-437-9024
Practice Address - Fax:559-437-0431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA483222080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A483220Medicaid
CA078104OtherHEATHNET PIN
CAH02560OtherBLUECROSS PIN
CAZZZ64423ZOtherBLUE SHIELD PIN