Provider Demographics
NPI:1518223197
Name:THANGAVEL, ARUL (MD)
Entity Type:Individual
Prefix:MR
First Name:ARUL
Middle Name:
Last Name:THANGAVEL
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 1:53 NEWBURG ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-1844
Mailing Address - Country:US
Mailing Address - Phone:415-713-6322
Mailing Address - Fax:
Practice Address - Street 1:500 PARNASSUS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2203
Practice Address - Country:US
Practice Address - Phone:415-713-6322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-08
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
DCMD043732207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program