Healthcare Provider Details

I. General information

NPI: 1366658627
Provider Name (Legal Business Name): NISHANT SINGH RANAWAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N JACKSON AVE STE 202
SAN JOSE CA
95116-1917
US

IV. Provider business mailing address

1553 DEVONSHIRE PL
MEDFORD OR
97504-7201
US

V. Phone/Fax

Practice location:
  • Phone: 408-508-6218
  • Fax: 408-351-0435
Mailing address:
  • Phone: 216-396-7455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberMD192398
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD192398
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: