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General NPI Number Information
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NPI Number | 1235280827
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Entity Type | Individual
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Provider Name | MADHU RAGHAVAN M.D
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 64 ASPEN WAY, SUITE102
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City | WATSONVILLE
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State | CA
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Zip | 95076
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Country | US
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Telephone | 831-724-9200
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Fax | 831-724-9205
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Provider Business Mailing Address
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Address Line | 1576 CALYPSO DR.,
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City | APTOS
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State | CA
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Zip | 95003
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Country | US
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Telephone | 831-662-1972
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A42945
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License Number State | CA
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