Healthcare Provider Details

I. General information

NPI: 1851896575
Provider Name (Legal Business Name): GEETHU GOPINATHAN NAIR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GEETHU SUJITH NAIR MD

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

505 PARNASSUS AVE
SAN FRANCISCO CA
94143-2204
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-7931
  • Fax:
Mailing address:
  • Phone: 415-476-7931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA173452
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA173452
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: