# RAVEENDRA NADARAJA, M.D., F.A.C.S., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861792558
- **Authorized official:** DR. GOWRI NADARAJA (MANAGER)
- **Authorized official phone:** (510) 538-2146

## Contact information

- **Practice address:** 20055 LAKE CHABOT RD STE 330, CASTRO VALLEY, CA 94546-5334
- **Practice address phone:** (510) 538-2146
- **Practice address fax:** (510) 538-7959
- **Mailing address:** 20055 LAKE CHABOT RD STE 330, CASTRO VALLEY, CA 94546-5334
- **Mailing address phone:** (510) 538-2146
- **Mailing address fax:** (510) 538-7959

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | — |
| 2086S0129X | Vascular Surgery Physician | — | — | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/27/2010
- **Last updated:** 11/03/2010