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General NPI Number Information
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NPI Number | 1760932230
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Entity Type | Organization
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Legal Business Name | ANTHER MEDICAL CORPORATION
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Dates
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Enumeration Date | 10/09/2016
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 1290 E SPRUCE AVE STE 103
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City | FRESNO
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State | CA
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Zip | 93720-3371
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Country | US
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Telephone | 323-382-5753
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Fax |
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Provider Business Mailing Address
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Address Line | 1290 EAST SPRUCE AVE,SUITE 103
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City | FRESNO
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State | CA
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Zip | 93720-3371
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Country | US
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Telephone | 559-840-0437
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Fax | 559-840-0037
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARY ANNE ARCILLA TABLIZO
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Credential | M.D.
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Telephone | 323-382-5753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080S0012X
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Taxonomy Name | Pediatric Sleep Medicine Physician
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License Number |
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License Number State |
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