Raviendran, Raveen Thekkeurimbil
Raviendran, Raveen Thekkeurimbil is an individual health care provider with primary practice located at 3626 Ruffin Rd , San Diego CA 92123-1810. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is his primary health care specialty. Raviendran, Raveen Thekkeurimbil can be contacted via phone (858) 565-9666.Contact Information
Primary practice address
3626 Ruffin Rd
San Diego CA 92123-1810
Phone: (858) 565-9666
Fax: (858) 565-9441
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | A 108610 | California |
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | A 108610 | California |
Profile Details
NPI number | 1700081080 |
---|---|
LBN Legal business name | Raviendran, Raveen Thekkeurimbil |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 18th, 2007 |
Last updated | Aug 22nd, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1700081080 | NPPES |
California | MEDICAID | 1700081080 |
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