Organization
R SRINIVASAN MD INC
Active
Other names
Monterey Park Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
RAMACHANDRAN SRINIVASAN MD (PRESIDENT)
(626) 458-8401
Entity
Organization
Contact information
Practice address
941 SO ATLANTIC BLVD, #101, MONTEREY PARK, CA 91754
(626) 458-8401
(626) 458-5606
Mailing address
941 SO ATLANTIC BLVD, #101, MONTEREY PARK, CA 91754
(626) 458-8401
(626) 458-5606
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A25280
CA
207R00000X
Internal Medicine Physician
A25280
CA
207RR0500X
Rheumatology Physician
Primary
A25280
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0008480
—
CA
01
—
WI4859
BLUE SHIELD
CA
Enumeration date
01/09/2007
Last updated
04/17/2008
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