DR. MARY ANNE ARCILLA TABLIZO (NPI# 1295889905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295889905 |
| Entity Type | Individual |
| Full Name | DR. MARY ANNE ARCILLA TABLIZO |
| Credential | M.D. |
| Practice Address |
9300 Valley Childrens Pl Madera CA 93638-8761 |
| Practice Telephone | 5593535550 |
| Practice Fax Number | 5593535587 |
| Mailing Telephone | 5593535550 |
| Mailing Fax Number | 5593535587 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0214X |
Pediatrics Specialization: Pediatric Pulmonology |
A76613 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GROUP PROVIDER NUMBER | GR0103350 | 01 |
| CA | STATE LICENSE NUMBER | A76613 | 01 |
| Street Address |
9300 VALLEY CHILDRENS PL |
| City | MADERA |
| State | CA |
| Zip Code | 93638-8761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962405753 | Fred H Laningham | Radiology | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2005-05-24 |
| 1043811953 | Ashley Nicole Peton | Pharmacist | 9300 Valley Childrens Pl, Madera, CA 93636-8762 | 2020-11-06 |
| 1063013308 | Samantha Carballo Austin | Social Worker | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-11-03 |
| 1982205217 | Stefanie Marie Gibbons | Social Worker | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-11-03 |
| 1114525128 | Kristin Leann Lokey | Social Worker | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-10-12 |
| 1770190969 | Mallory King | Physician Assistant | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-09-30 |
| 1356957161 | Sabrina Star Tovar | Audiologist | 9300 Valley Childrens Pl, Madera, CA 93636-8762 | 2020-09-17 |
| 1790391621 | Alyssa Catherine Nakaguchi | Pharmacist | 9300 Valley Childrens Pl, Madera, CA 93636-8762 | 2020-09-16 |
| 1740894773 | Heather Goossen | Pharmacist | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-09-08 |
| 1184236820 | Renzio Menico Bantayan Apostol | Pharmacist | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-08-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639644628 | Kevin Violette | Physician Assistant | 344 E Sixth Street, Madera, CA 93638 | 2018-10-05 |
| 1265939185 | Kimberly Lenise Bradley | Clinic/Center | 1159 Country Club Drive, Madera, CA 93638 | 2018-04-08 |
| 1255849584 | Cathy Castillo | Technician, Health Information | 2935113 1/2 Ave, Madera, CA 93638 | 2018-01-22 |
| 1164944195 | Xavier Pablo Garcia | Case Manager/Care Coordinator | 14241 Road, Madera, CA 93638 | 2017-07-12 |
| 1568982460 | Cruz Amelia Macias | Case Manager/Care Coordinator | 14241 Rd 28, Madera, CA 93638 | 2017-06-21 |
| 1144699588 | Joanna Arredondo | Counselor | 344 E. 6th St., Madera, CA 93638 | 2015-09-16 |
| 1144625997 | Pushkal Jadaun | Internal Medicine | 124 Sa Street, Madera, CA 93638 | 2014-10-22 |
| 1598022600 | Valarie Ann Shaffer | Counselor | 14227 Road 28, Madera, CA 93638 | 2012-04-13 |
| 1053555904 | Patricia Ann Alexander | Nurse Practitioner | 344 E. 4th St, Madera, CA 93638 | 2009-04-22 |
| 1629246913 | Lynn Doyle Cogdill | Technician, Other | 14427 Road 28, Madra, CA 93638 | 2008-02-20 |
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| Taxonomy Code | 2080P0214X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Pulmonology |
| A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649639832 | Valley Children's Medical Group - Dept of Pulmonology | Pediatrics | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2016-02-16 |
| 1629434113 | Valley Children's Specialty Medical Group - Pulmonology | Pediatrics | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2016-01-13 |
| 1285788398 | Valley Pediatric Pulmonary Medical Corp. | Pediatrics | 9300 Valley Childrens Pl, Madera, CA 93638-8761 | 2007-01-23 |
| 1003969429 | Sudhakar Reddivalam | Pediatrics | 9300 Valley Childrens Pl, Madera, CA 93638-8761 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659532117 | Salman Raza Khan | Pediatrics | 65 N Madison Ave Ste 701, Pasadena, CA 91101-2046 | 2008-06-18 |
| 1932384682 | University Childrens Medical Group | Pediatrics | 4650 W Sunset Blvd # 83, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1912188053 | Sebnem Ozdogan | Pediatrics | 3525 Pelandale Ave, Modesto, CA 95356-9781 | 2007-11-16 |
| 1316165384 | Cesar Chavarria, Md, Inc | Pediatrics | 18425 Burbank Blvd Suite 719, Tarzana, CA 91356 | 2007-04-23 |
| 1528184603 | Muhammad M. Saeed | Pediatrics | 4700 W Sunset Blvd Fl 3, Kaiser Permanente Dept of Pediatrics, Los Angeles, CA 90027-6082 | 2007-03-21 |
| 1528194024 | Alan Howard Cohen | Pediatrics | 3180 Porter Dr, Palo Alto, CA 94304-1212 | 2007-02-26 |
| 1720164080 | Carlos Eduardo Milla | Pediatrics | 770 Welch Rd Ste 350, Stanford University, Palo Alto, CA 94304-1523 | 2006-10-30 |
| 1992892822 | Amy Nevin Harrison | Pediatrics | 1501 Superior Ave Ste 202, Newport Beach, CA 92663-3640 | 2006-10-10 |
| 1659468759 | Christopher Endom Harris | Pediatrics | 8700 Beverly Blvd # Nt-4230, West Hollywood, CA 90048-1804 | 2006-10-09 |
| 1760580062 | Arnold C.g. Platzker | Pediatrics | 4650 W. Sunset Blvd, Los Angeles, CA 90027 | 2006-09-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.