Provider Demographics
NPI:1194784678
Name:RAMCHANDRAN, ASHA (MD)
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:
Last Name:RAMCHANDRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHA
Other - Middle Name:
Other - Last Name:VENKATESWARAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11875 DUBLIN BLVD
Mailing Address - Street 2:SUITE C 140
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2843
Mailing Address - Country:US
Mailing Address - Phone:925-587-2500
Mailing Address - Fax:925-587-2511
Practice Address - Street 1:5720 STONERIDGE MALL RD
Practice Address - Street 2:SUITE 240
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2828
Practice Address - Country:US
Practice Address - Phone:925-463-1234
Practice Address - Fax:925-463-9599
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63418208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics