Basic Information
| Provider Information | |||||||||
| NPI: | 1043355019 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MADHAVAN | ||||||||
| FirstName: | RANGANATHAN | ||||||||
| MiddleName: | GURU | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7805 PARK RIVER OAK CIR | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958315816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412919080 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4150 V ST | ||||||||
| Address2: | SUITE 3400 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958171460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167347506 | ||||||||
| FaxNumber: | 9167344810 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2007 | ||||||||
| LastUpdateDate: | 10/18/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD27726 | OR | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | MD27726 | OR | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | P0757 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | A118613 | CA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.