Healthcare Provider Details

I. General information

NPI: 1124551213
Provider Name (Legal Business Name): YAANIK BINOY DESAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2017
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 VAN NESS AVE FL 5
SAN FRANCISCO CA
94109-6978
US

IV. Provider business mailing address

453 WISNOM AVE
SAN MATEO CA
94401-2421
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-6500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA161331
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberA161331
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: