Provider Demographics
NPI:1891288973
Name:RAICHANDANI, SURBHI (MD)
Entity type:Individual
Prefix:DR
First Name:SURBHI
Middle Name:
Last Name:RAICHANDANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 EL CAMINO REAL UNIT C212
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-5278
Mailing Address - Country:US
Mailing Address - Phone:786-212-4223
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR DEPT OF
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2203
Practice Address - Country:US
Practice Address - Phone:650-723-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA1835872085B0100X
GA980302085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program