Healthcare Provider Details

I. General information

NPI: 1053846410
Provider Name (Legal Business Name): MEERA RAGAVAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2017
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2238 GEARY BLVD
SAN FRANCISCO CA
94115-3416
US

IV. Provider business mailing address

2000 BROADWAY
OAKLAND CA
94612-2304
US

V. Phone/Fax

Practice location:
  • Phone: 415-833-3692
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA158519
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: