Provider Demographics
NPI:1346478385
Name:PERIYANAYAGAM, USHA (MD)
Entity Type:Individual
Prefix:DR
First Name:USHA
Middle Name:
Last Name:PERIYANAYAGAM
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 1:680 MISSION ST
Mailing Address - Street 2:APT 14N
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-4000
Mailing Address - Country:US
Mailing Address - Phone:270-853-9302
Mailing Address - Fax:
Practice Address - Street 1:680 MISSION ST
Practice Address - Street 2:APT 14N
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-4000
Practice Address - Country:US
Practice Address - Phone:270-853-9302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-29
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125055892207P00000X
CAA135431207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine