Healthcare Provider Details

I. General information

NPI: 1821067547
Provider Name (Legal Business Name): SMRUTIREKHA MISRA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5860 OWENS DR STE 220
PLEASANTON CA
94588-3980
US

IV. Provider business mailing address

5860 OWENS DR STE 220
PLEASANTON CA
94588-3980
US

V. Phone/Fax

Practice location:
  • Phone: 925-224-0720
  • Fax: 925-224-0713
Mailing address:
  • Phone: 925-224-0720
  • Fax: 925-224-0713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA063713
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: