MEDICARE: MEENA AMMANI SWAMINATHAN 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
1	207R00000X	Internal Medicine Physician	A98376	CA

General Provider Information

NPI Number	:	1710184288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEENA AMMANI SWAMINATHAN MD

Provider Business Mailing Address
First Line	:	795 WILLOW RD BLDG 334
Second Line	:
City	:	MENLO PARK
State	:	CA
Zip	:	94025-2539
Country	:	US
Telephone Number	:	650-599-5890
Fax Number	:	650-321-7425

Provider Business Practice Location Address
First Line	:	795 WILLOW ROAD BUILDING 334
Second Line	:
City	:	MENLO PARK
State	:	CA
Zip	:	94025-3542
Country	:	US
Telephone Number	:	650-599-3890
Fax Number	:	650-321-7425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2007
Last Update Date	:	04/20/2011

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