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General NPI Number Information
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NPI Number | 1235387259
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Entity Type | Individual
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Provider Name | RAVI MADHURE SHANKAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 18111 BROOKHURST ST STE 6100
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6728
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Country | US
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Telephone | 657-241-9755
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Fax | 714-907-4407
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Provider Business Mailing Address
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Address Line | 18111 BROOKHURST ST STE 6100
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6728
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Country | US
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Telephone | 657-241-9755
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Fax | 714-907-4407
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | A107718
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License Number State | CA
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