Provider Demographics
NPI:1134486095
Name:RAVICHANDRAN, SANDHYA (MD)
Entity Type:Individual
Prefix:MS
First Name:SANDHYA
Middle Name:
Last Name:RAVICHANDRAN
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 1:22306 CITY CENTER DR
Mailing Address - Street 2:APT 3403
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-2844
Mailing Address - Country:US
Mailing Address - Phone:801-440-8937
Mailing Address - Fax:
Practice Address - Street 1:2175 N CALIFORNIA BLVD
Practice Address - Street 2:SUITE 425
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-3579
Practice Address - Country:US
Practice Address - Phone:801-440-8937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA133131207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology