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Organization
PRADEEPA SELVAKUMAR MD INC, A CALIFORNIA PROFESSIONAL CORPORATION
Active
Organization
PRADEEPA SELVAKUMAR MD INC, A CALIFORNIA PROFESSIONAL CORPORATION
Active
Other names
San Mateo Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRADEEPA SELVAKUMAR MD (OWNER)
(650) 435-8211
Entity
Organization
Contact information
Practice address
101 S SAN MATEO DR STE 102, SAN MATEO, CA 94401-3840
(650) 435-8211
(844) 965-9436
Mailing address
2889 BAZE RD, SAN MATEO, CA 94403-3436
(415) 778-0813
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912090226
OTHER INSURANCES
CA
Enumeration date
02/05/2019
Last updated
02/05/2019
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