Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | A46570 | CA |
NPI | 1013988807 |
---|---|
Provider Name | Shankar Raman |
First Address | Bakersfield, CA 93389-9536 |
Second Address | Bakersfield, CA 93301-1900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 13/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D19472 | (02) |