Healthcare Provider Details

I. General information

NPI: 1336301852
Provider Name (Legal Business Name): SWAMINATHAN MURUGAPPAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1067 TRUMPET VINE LN
SAN RAMON CA
94582-5396
US

IV. Provider business mailing address

1067 TRUMPET VINE LN
SAN RAMON CA
94582-5396
US

V. Phone/Fax

Practice location:
  • Phone: 267-992-2747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD60086317
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: