Healthcare Provider Details

I. General information

NPI: 1407941172
Provider Name (Legal Business Name): RAMACHANDRAN RAJAGOPALAN M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6235 N FRESNO ST SUITE # 103
FRESNO CA
93710-5269
US

IV. Provider business mailing address

6235 N FRESNO ST SUITE # 103
FRESNO CA
93710-5269
US

V. Phone/Fax

Practice location:
  • Phone: 559-449-4350
  • Fax: 559-449-4358
Mailing address:
  • Phone: 559-449-4350
  • Fax: 559-449-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA31657
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: