Healthcare Provider Details

I. General information

NPI: 1821386962
Provider Name (Legal Business Name): GEETA RAMAN KUTTY M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2011
Last Update Date: 10/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2331 MONTPELIER DR STE B
SAN JOSE CA
95116
US

IV. Provider business mailing address

2331 MONTPELIER DR STE B
SAN JOSE CA
95116-1673
US

V. Phone/Fax

Practice location:
  • Phone: 408-347-9001
  • Fax: 408-347-9004
Mailing address:
  • Phone: 408-347-9001
  • Fax: 408-347-9004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number158918
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: