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NPI Code Detail

MEDICARE: THIRUKKANANKUDI V. VISWANATHAN MD

MEDICARE: THIRUKKANANKUDI V. VISWANATHAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianA51260CA

General Provider Information

NPI Number : 1700994373
Entity Type Code : Individual
Provider Name (Legal Business Name) : THIRUKKANANKUDI V. VISWANATHAN MD
Provider Business Mailing Address
First Line : 2100 POWELL ST STE 900
Second Line :
City : EMERYVILLE
State : CA
Zip : 94608-1844
Country : US
Telephone Number : 888-556-5619
Fax Number :
Provider Business Practice Location Address
First Line : 520 WEST 'I' STREET
Second Line :
City : LOS BANOS
State : CA
Zip : 93635-3419
Country : US
Telephone Number : 209-826-0591
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2006
Last Update Date : 03/09/2011

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