Healthcare Provider Details

I. General information

NPI: 1811924319
Provider Name (Legal Business Name): RANI V RAMACHANDRAN MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2081 FOREST AVE STE 1
SAN JOSE CA
95128-4841
US

IV. Provider business mailing address

2081 FOREST AVE STE 1
SAN JOSE CA
95128-4841
US

V. Phone/Fax

Practice location:
  • Phone: 408-294-2399
  • Fax: 408-294-1753
Mailing address:
  • Phone: 408-294-2399
  • Fax: 408-294-1753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA48819
License Number StateCA

VIII. Authorized Official

Name: DR. RANI V RAMACHANDRAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 408-294-2399