Healthcare Provider Details

I. General information

NPI: 1730344482
Provider Name (Legal Business Name): SHASHI SHRAVANA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 E CALAVERAS BLVD
MILPITAS CA
95035-5491
US

IV. Provider business mailing address

6600 BRUCEVILLE RD
SACRAMENTO CA
95823
US

V. Phone/Fax

Practice location:
  • Phone: 216-798-6988
  • Fax:
Mailing address:
  • Phone: 216-798-6988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA117735
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: