Provider Demographics
NPI:1467413344
Name:NATHAN, RAGU CHANDRASEKHARAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RAGU
Middle Name:CHANDRASEKHARAN
Last Name:NATHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CHANDRASEKHARAN
Other - Middle Name:
Other - Last Name:RAGUNATHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-723-4000
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA552782085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0141763Medicaid
CACZ295YMedicare PIN
MAF85750Medicare UPIN
MANAA32982Medicare ID - Type Unspecified
CACZ295ZMedicare PIN