Provider Demographics
NPI:1386625754
Name:NARAYAN, GEETHA (MD)
Entity Type:Individual
Prefix:
First Name:GEETHA
Middle Name:
Last Name:NARAYAN
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 1:54 HAHNEMANN LN
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-7208
Mailing Address - Country:US
Mailing Address - Phone:617-413-2705
Mailing Address - Fax:
Practice Address - Street 1:3230 BEARD RD
Practice Address - Street 2:SUITE 1
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3673
Practice Address - Country:US
Practice Address - Phone:707-253-7005
Practice Address - Fax:707-253-7271
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA43466207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA167771Medicare PIN
CACA181135Medicare PIN
MA10028OtherHPHC
MA2037670OtherAETNA
MA043466OtherTUFTS
MA31-00020OtherUNITED HEALTHCARE
MA5102053OtherBCBS
MAJ02053OtherBCBS
MA6165478Medicaid