| Srividya Venkataraman MD Inc | |
|
3816 Woodruff Ave #406 Long Beach CA 90808-2147 | |
| (562) 497-9314 | |
| (562) 497-9315 |
| Full Name | Srividya Venkataraman MD Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 3816 Woodruff Ave, Long Beach, California |
| Authorized Official Name and Position | Srividya Venkataraman (PRESIDENT) |
| Authorized Official Contact | 5624979314 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Srividya Venkataraman MD Inc 3816 Woodruff Ave #406 Long Beach CA 90808-2147 Ph: (562) 497-9314 | Srividya Venkataraman MD Inc 3816 Woodruff Ave #406 Long Beach CA 90808-2147 Ph: (562) 497-9314 |
| NPI Number | 1356429054 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4183677727 |
|---|---|
| Medicare Enrollment ID | O20050223000904 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356429054 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A55317 (California) | Primary |
| Provider Name | Srividya Venkataraman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063522217 PECOS PAC ID: 3870546427 Enrollment ID: I20050224000275 |
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