Provider Demographics
NPI:1316574650
Name:RAMASWAMY, PADMANABHAN
Entity Type:Individual
Prefix:
First Name:PADMANABHAN
Middle Name:
Last Name:RAMASWAMY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8718 GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-1214
Mailing Address - Country:US
Mailing Address - Phone:626-286-5061
Mailing Address - Fax:
Practice Address - Street 1:8718 GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91775-1214
Practice Address - Country:US
Practice Address - Phone:626-286-5061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant