Provider Demographics
NPI:1104220193
Name:PLAXGEN INC
Entity Type:Organization
Organization Name:PLAXGEN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANMUGAVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MADASAMY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:650-452-2856
Mailing Address - Street 1:428 OAKMEAD PKWY
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-4708
Mailing Address - Country:US
Mailing Address - Phone:650-452-2856
Mailing Address - Fax:408-331-3851
Practice Address - Street 1:428 OAKMEAD PKWY
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4708
Practice Address - Country:US
Practice Address - Phone:650-452-2856
Practice Address - Fax:408-331-3851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA05D2084226291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory