Basic Information
| Provider Information | |||||||||
| NPI: | 1487327151 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VARSUHAWA | ||||||||
| FirstName: | RAVINDER | ||||||||
| MiddleName: | SINGH | ||||||||
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| OtherLastName: | SINGH | ||||||||
| OtherFirstName: | RAVINDER | ||||||||
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| OtherCredential: | NP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2718 HOLLY ST | ||||||||
| Address2: | |||||||||
| City: | SAN PABLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 948062289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5106218221 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3555 CESAR CHAVEZ | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941104403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156006000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2021 | ||||||||
| LastUpdateDate: | 07/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 95017914 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.