Provider Demographics
NPI:1013988807
Name:RAMAN, SHANKAR (MD,MPH)
Entity type:Individual
Prefix:
First Name:SHANKAR
Middle Name:
Last Name:RAMAN
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 STOCKDALE HWY STE M10-173
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-1091
Mailing Address - Country:US
Mailing Address - Phone:661-632-6963
Mailing Address - Fax:
Practice Address - Street 1:11001 HILAIRE BLAISE DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3708
Practice Address - Country:US
Practice Address - Phone:661-632-6963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46570207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
D19472Medicare UPIN