Healthcare Provider Details

I. General information

NPI: 1437103926
Provider Name (Legal Business Name): BHANUMATHI GURUSWAMI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1783 EL CAMINO REAL
BURLINGAME CA
94010-3205
US

IV. Provider business mailing address

PO BOX 7793
SAN FRANCISCO CA
94120-7793
US

V. Phone/Fax

Practice location:
  • Phone: 650-696-5400
  • Fax: 650-696-5208
Mailing address:
  • Phone: 503-372-2740
  • Fax: 503-372-2754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA65567
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: