Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 062075 | GA |
N | 2080N0001X | Neonatal-Perinatal Doctor | A70010 | CA |
NPI | 1083752851 |
---|---|
Provider Name | Deepa Ranganathan |
First Address | Gainesville, GA 30503-0658 |
Second Address | Gainesville, GA 30501-3715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 10/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1447398300 | NPI GROUP # (01) | CA |
202921026 | TAX ID# (01) | CA |