1740287978 NPI number — GEETHA VARMA M.D

Table of content: GEETHA VARMA M.D (NPI 1740287978)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740287978 NPI number — GEETHA VARMA M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VARMA
Provider First Name:
GEETHA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740287978
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4363
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALINAS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93912-4363
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-755-1701
Provider Business Mailing Address Fax Number:
831-755-1702

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
505 E ROMIE LN
Provider Second Line Business Practice Location Address:
A
Provider Business Practice Location Address City Name:
SALINAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93901-4031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-755-1701
Provider Business Practice Location Address Fax Number:
831-755-1702
Provider Enumeration Date:
07/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  C51653 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ZZZ67456Z . This is a "BLUE SHIELD PROVIDER NUMBER GILROY LOCATION" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: CA153403 . This is a "MEDICARE PTAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: HI725A . This is a "MEDICARE GROUP PTAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZZ71527Z . This is a "BLUE SHIELD PROVIDER NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: P00155700 . This is a "RAILROAD PROVIDER NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 00C516530 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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