Navin Mallavaram, M.D., Inc.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

A104871 Issued in CA

Legal business name

NAVIN MALLAVARAM, M.D., INC.

Practice address

5924 Stoneridge Dr
Suite 206
Pleasanton, CA 94588-2887

Phone

(925) 469-9120

NPI assigned

Oct 31, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Navin Mallavaram, M.D.NPI 1962677724

Title

President

Phone

(925) 469-9120

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Navin A Mallavaram, M.D.

  • Interventional Pain Medicine Physician
  • Pleasanton, CA
  • NPI 1962677724
  Medicare reassignment NPD Authorized official
• Susannah Ruth Feder, PSY.D

  • Clinical Psychologist
  • Pleasanton, CA
  • NPI 1992822803
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386720000000",
    "number": "1164708582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5924 STONERIDGE DR",
            "address_2": "SUITE 206",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882887",
            "telephone_number": "925-469-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5924 STONERIDGE DR",
            "address_2": "SUITE 206",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882887",
            "telephone_number": "925-469-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAVIN MALLAVARAM, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-31",
        "last_updated": "2013-12-11",
        "status": "A",
        "authorized_official_last_name": "MALLAVARAM",
        "authorized_official_first_name": "NAVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-469-9120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A104871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard George Nassab, D.C.
• Sony Ruth Nathaniel, MA, LMFT
• National Vision, Inc.
• National Vision, Inc.
• Clarissa Navarro, BA
• Nisha Perampalli Nayak, DMD
• Gerald Roy Nazareno, MD
• Sierra Lashawn Nazel
• Lauren Ashley Nelson, M.D.
• Ruku Nepal

• Interventional Pain Medicine Physician in Pleasanton, CA
• Providers in Pleasanton, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.