Healthcare Provider Details

I. General information

NPI: 1912724477
Provider Name (Legal Business Name): VELUPANDIAN GURUSWAMY MBBS,DA,FCARCSI,FRCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 52ND ST
OAKLAND CA
94609-1809
US

IV. Provider business mailing address

219 9TH AVE UNIT 818
OAKLAND CA
94606-5192
US

V. Phone/Fax

Practice location:
  • Phone: 914-320-8058
  • Fax:
Mailing address:
  • Phone: 914-320-8058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberSPI847
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: