Provider Demographics
NPI:1396775847
Name:TIWARI, RATAN L (MD)
Entity type:Individual
Prefix:DR
First Name:RATAN
Middle Name:L
Last Name:TIWARI
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 1:949 CALHOUN PL
Mailing Address - Street 2:SUITE D
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4403
Mailing Address - Country:US
Mailing Address - Phone:951-652-8000
Mailing Address - Fax:951-929-6431
Practice Address - Street 1:949 CALHOUN PL
Practice Address - Street 2:SUITE D
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4403
Practice Address - Country:US
Practice Address - Phone:951-652-8000
Practice Address - Fax:951-929-6431
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35113207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A351130Medicaid
CABH564YOtherMEDICARE PTAN
CAA27686Medicare UPIN
CA00A351130Medicare ID - Type Unspecified