Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | A 073586 | CA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | A 073586 | CA |
Y | 207R00000X | Internist | A73586 | CA |
Y | 111NI0900X | Internist | A73586 | CA |
NPI | 1699725440 |
---|---|
Provider Name | Dr. Sampath K. Ramakrishnan |
First Address | Pleasanton, CA 94588-8365 |
Second Address | Pleasanton, CA 94588-8365 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 07/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ZZZ27952Z | PTAN (01) | CA |