Organization Active NPI

Nirmala Kannan M.D. a Professional Corporation

  • Internal Medicine Physician
  • Hayward, CA
National Provider Identifier
1174605158
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A52786 Issued in CA
Legal business name
NIRMALA KANNAN M.D. A PROFESSIONAL CORPORATION
Practice address
1090 La Playa Dr
Hayward, CA 94545-2142
Phone
(510) 785-5555
Fax
(510) 280-3116
NPI assigned
Oct 19, 2006
Last updated
Jun 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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

Authorized official

Name
Dr. Nirmala Kannan, M.D.NPI 1114014172
Title
Owner
Phone
(650) 574-3778

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A52786 CA Primary

Addresses

Primary practice location

1090 La Playa Dr
Hayward, CA 94545-2142

Mailing address

PO Box 4760
Foster City, CA 94404-0760
Phone (650) 574-3778

Other identifiers 1

IdentifierTypeStateIssuer
00A527860MedicaidCA

National Provider Directory

National Provider Directory

Locations

39022 Presidio Way
Fremont, CA 94538
Phone (510) 792-3743

27171 Calaroga Ave
Ste 3
Hayward, CA 94545
Phone (650) 316-5777

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276128000000",
    "number": "1174605158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4760",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "944040760",
            "telephone_number": "650-574-3778",
            "fax_number": "650-574-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 LA PLAYA DR",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945452142",
            "telephone_number": "510-785-5555",
            "fax_number": "510-280-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIRMALA KANNAN M.D. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2010-06-10",
        "status": "A",
        "authorized_official_last_name": "KANNAN",
        "authorized_official_first_name": "NIRMALA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-574-3778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A52786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A527860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.