Healthcare Provider Details

I. General information

NPI: 1053169797
Provider Name (Legal Business Name): PAVEL ZHURAVLEV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 05/08/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 E 31ST ST QIC 22134 DEPARTMENT OF SURGERY
OAKLAND CA
94602
US

IV. Provider business mailing address

1411 E 31ST ST QIC 22134 DEPARTMENT OF SURGERY
OAKLAND CA
94602
US

V. Phone/Fax

Practice location:
  • Phone: 510-437-4401
  • Fax:
Mailing address:
  • Phone: 510-437-4401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: