Healthcare Provider Details

I. General information

NPI: 1013780188
Provider Name (Legal Business Name): ARAVIND RANGARAJ MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2023
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 JOSE FIGUERES AVE STE 225
SAN JOSE CA
95116-1588
US

IV. Provider business mailing address

1560 BIRD AVE
SAN JOSE CA
95125-1818
US

V. Phone/Fax

Practice location:
  • Phone: 408-929-5610
  • Fax: 650-587-1372
Mailing address:
  • Phone: 408-929-5610
  • Fax: 650-587-1372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ARAVIND T RANGARAJ
Title or Position: PRESIDENT
Credential: MD
Phone: 774-239-1960