Individual
GOUTHAM GANESAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD/PHD
Contact information
Practice address
5755 COTTLE RD BLDG 24, SAN JOSE, CA 95123-3640
(408) 972-3095
Mailing address
5755 COTTLE RD BLDG 24, SAN JOSE, CA 95123-3640
(408) 972-3095
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A171590
CA
390200000X
Student in an Organized Health Care Education/Training Program
226934
NC
Other
Enumeration date
04/25/2017
Last updated
10/29/2024
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