MEDICARE: DR. PARVATHI NANJUNDIAH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	35-080249	OH
2	2084P0800X	Psychiatry Physician	A65120	CA

General Provider Information

NPI Number	:	1093833352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PARVATHI NANJUNDIAH MD

Provider Business Mailing Address
First Line	:	4546 EL CAMINO REAL STE B7
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94022-1069
Country	:	US
Telephone Number	:	866-362-4246
Fax Number	:	650-260-6030

Provider Business Practice Location Address
First Line	:	4546 EL CAMINO REAL STE B7
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94022-1069
Country	:	US
Telephone Number	:	866-362-4246
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	02/05/2024

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