MEDICARE: DR. RAMU THIAGARAJAN M.D.

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	2084N0400X	Neurology Physician	A95502	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	ZZZ05543Z	OTHER	CA	MEDICARE GROUP PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ69517Z	OTHER	CA	BLUE SHIELD GROUP PIN
2	00A955020	OTHER	CA	BLUE SHIELD PIN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841203783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMU THIAGARAJAN M.D.

Provider Business Mailing Address
First Line	:	382 N. PEARSON DR.
Second Line	:
City	:	PORTERVILLE
State	:	CA
Zip	:	93257-3368
Country	:	US
Telephone Number	:	559-783-0100
Fax Number	:	559-783-0200

Provider Business Practice Location Address
First Line	:	382 NORTH PEARSON DRIVE
Second Line	:
City	:	PORTERVILLE
State	:	CA
Zip	:	93257-3368
Country	:	US
Telephone Number	:	559-783-0100
Fax Number	:	559-783-0200

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	03/27/2024

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