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Individual

BHAVANA RAVIPATI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1130 BIRD AVE, SAN JOSE, CA 95125-1700
(408) 295-7768
Mailing address
999 MILLS CORNER LN, SAN JOSE, CA 95122-3248
(510) 766-3855

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
83631
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
83631
CA
Enumeration date
03/11/2021
Last updated
03/12/2021
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