Healthcare Provider Details

I. General information

NPI: 1861248999
Provider Name (Legal Business Name): NARESH RAMARAJAN MD, INC. A MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 E WILSON AVE STE 245
GLENDALE CA
91206-4356
US

IV. Provider business mailing address

520 E WILSON AVE STE 245
GLENDALE CA
91206-4356
US

V. Phone/Fax

Practice location:
  • Phone: 650-796-5447
  • Fax:
Mailing address:
  • Phone: 650-796-5447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NARESH RAMARAJAN
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 650-796-5447