Individual
DR. SOURAV RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1783 EL CAMINO REAL, MILLS PENINSULA PATHOLOGY DEPT, BURLINGAME, CA 94010-3205
(650) 696-5611
Mailing address
383 E GRAND AVE, SUITE A, SOUTH SAN FRANCISCO, CA 94080-6234
(650) 616-2951
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
C52780
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C52780
CA MEDICAL LICENSE
CA
Enumeration date
04/17/2007
Last updated
10/19/2007
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