1275611873 NPI number — JANAKI N. RAMANATHAN MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275611873 NPI number — JANAKI N. RAMANATHAN MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

RAMANATHAN

Provider First Name:

JANAKI

Provider Middle Name:

N.

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

F

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:

1275611873

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

09/23/2020

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 6102

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

NOVATO

Provider Business Mailing Address State Name:

CA

Provider Business Mailing Address Postal Code:

94948-6102

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

415-884-3418

Provider Business Mailing Address Fax Number:

415-883-3406

Provider First Line Business Practice Location Address:

2351 CLAY ST STE 100

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

SAN FRANCISCO

Provider Business Practice Location Address State Name:

CA

Provider Business Practice Location Address Postal Code:

94115-1931

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

415-600-3143

Provider Business Practice Location Address Fax Number:

415-600-3123

Provider Enumeration Date:

11/01/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0202X , with the licence number:  25MA08403700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 248102 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 25.000109 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 25945 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 49037 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: K7874 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 24315 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 11524 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: MEDS6218 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 38047 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 46252 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 12619 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 036.119210 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 4516 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: A80398 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 1275611873 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
• Identifier: 320447 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
• Identifier: 8947270 . This is a "L&I CVCP" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0229781 . This is a "L & I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 1275611873 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
• Identifier: 8505539 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
• Identifier: 00A803980 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: 200215450 , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
• Identifier: 5578RA . This is a "REGENCE BLUE SHIELD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0168289 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
• Identifier: 19800070 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
• Identifier: P00075447 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".