Raviendran, Raveen Thekkeurimbil

Raviendran, Raveen Thekkeurimbil is an individual health care provider with primary practice located at 3626 Ruffin Rd , San Diego CA 92123-1810. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is his primary health care specialty. Raviendran, Raveen Thekkeurimbil can be contacted via phone (858) 565-9666.

Contact Information

Primary practice address
3626 Ruffin Rd San Diego CA 92123-1810
Phone: (858) 565-9666
Fax: (858) 565-9441
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A 108610 California
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X A 108610 California

Profile Details

NPI number 1700081080
LBN Legal business name Raviendran, Raveen Thekkeurimbil
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2007
Last updated Aug 22nd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700081080 NPPES
California MEDICAID 1700081080

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