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General NPI Number Information
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NPI Number | 1922265917
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Entity Type | Organization
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Legal Business Name | SANAGARAM S. SHANTHARAM M.D. INC.
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | 7065 N MAPLE AVE SUITE 102
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City | FRESNO
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State | CA
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Zip | 93720-8013
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Country | US
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Telephone | 559-322-0887
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Fax |
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Provider Business Mailing Address
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Address Line | 7065 N MAPLE AVE SUITE 102
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City | FRESNO
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State | CA
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Zip | 93720-8013
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Country | US
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Telephone | 559-322-0887
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SUZANNE RAMIREZ
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Credential |
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Telephone | 559-322-0887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A52010
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License Number State | CA
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