Basic Information
| Provider Information | |||||||||
| NPI: | 1063467355 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALAGAPPAN | ||||||||
| FirstName: | RAVI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2242 CAMINO RAMON STE 100 | ||||||||
| Address2: | |||||||||
| City: | SAN RAMON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945831363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9253270015 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2242 CAMINO RAMON STE 100 | ||||||||
| Address2: | |||||||||
| City: | SAN RAMON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94583 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9253270015 | ||||||||
| FaxNumber: | 9253270095 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 12/06/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 28227 | TN | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | G74076 | CA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | G74076 | 01 | CA | MEDICAL LICENSE | OTHER |