Individual
HARENDRA KESHAVLAL PUNATAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
(707) 573-6166
(707) 573-6165
Mailing address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
(707) 525-6485
(707) 573-6165
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A40868
CA
207RI0011X
Interventional Cardiology Physician
A40868
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A408680
BLUE SHIELD OF CALIFORNIA
CA
05
—
00A408680
—
CA
01
—
060017510
RAILROAD MEDICARE
CA
Enumeration date
07/13/2005
Last updated
02/08/2012
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