Healthcare Provider Details

I. General information

NPI: 1336143882
Provider Name (Legal Business Name): MURALI DHARAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 01/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 EL CAPITAN DR SUITE 120
DANVILLE CA
94526-6258
US

IV. Provider business mailing address

1320 EL CAPITAN DR SUITE 120
DANVILLE CA
94526-6258
US

V. Phone/Fax

Practice location:
  • Phone: 925-676-2600
  • Fax: 925-689-3102
Mailing address:
  • Phone: 925-676-2600
  • Fax: 925-689-3102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberA52856
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberA52856
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: