Individual
SURAVI GONGULEE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, MD
Contact information
Practice address
401 CRESCENT CT APT 4309, SAN FRANCISCO, CA 94134-3338
(415) 609-4630
Mailing address
410 E PARKCENTER CIR N, SAN BERNARDINO, CA 92408-2869
(909) 403-6950
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
173587
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2018
Last updated
11/17/2022
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