Provider Demographics
NPI:1750545141
Name:PADMANABHAN, SRIRANJANI PARTHASARATHY (MD)
Entity type:Individual
Prefix:
First Name:SRIRANJANI
Middle Name:PARTHASARATHY
Last Name:PADMANABHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:SRIRANJANI
Other - Middle Name:
Other - Last Name:PARTHASARATHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1001 POTRERO AVE # 4M
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVE # 4M
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-8304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261252207W00000X
CAA138616207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology