Provider Demographics
NPI:1346307113
Name:SUBRAMANYAN, GIRISH SHEKAR (MD)
Entity Type:Individual
Prefix:DR
First Name:GIRISH
Middle Name:SHEKAR
Last Name:SUBRAMANYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626A UNION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4507
Mailing Address - Country:US
Mailing Address - Phone:415-928-1234
Mailing Address - Fax:415-928-1222
Practice Address - Street 1:1626A UNION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4507
Practice Address - Country:US
Practice Address - Phone:415-928-1234
Practice Address - Fax:415-928-1222
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA734202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH63894Medicare UPIN