Healthcare Provider Details

I. General information

NPI: 1730358532
Provider Name (Legal Business Name): AVINASH NARI RAMCHANDANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 02/18/2023
Certification Date: 02/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 DOYLE PARK DR STE 300
SANTA ROSA CA
95405-4559
US

IV. Provider business mailing address

PO BOX 5510
NAPA CA
94581-0510
US

V. Phone/Fax

Practice location:
  • Phone: 707-303-8320
  • Fax: 707-546-4062
Mailing address:
  • Phone: 707-252-9660
  • Fax: 707-258-2780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberN6595
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA96965
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: