Individual
DIVYA T RAVIENDRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3151 CROW CANYON PL, SAN RAMON, CA 94583-1359
(888) 663-6331
Mailing address
1 EMBARCADERO CTR STE 1900, SAN FRANCISCO, CA 94111-3723
(415) 658-6791
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A81826
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A81826
M.D LICENSE
CA
Enumeration date
06/27/2006
Last updated
09/14/2023
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