Indu Raghavan MD Inc

Primary specialty

Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X

License

A054464 Issued in CA

Legal business name

INDU RAGHAVAN MD INC

Practice address

516 Pennsfield PL
Suite 105
Thousand Oaks, CA 91360

Phone

(805) 496-8003

Fax

(805) 496-8303

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Indu Raghavan, MD

Title

Owner

Phone

(805) 496-8003

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1497974091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 PENNSFIELD PL",
            "address_2": "SUITE 105",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91360",
            "telephone_number": "805-496-8003",
            "fax_number": "805-496-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 PENNSFIELD PL",
            "address_2": "SUITE 105",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91360",
            "telephone_number": "805-496-8003",
            "fax_number": "805-496-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDU RAGHAVAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "RAGHAVAN",
        "authorized_official_first_name": "INDU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-496-8003",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "CA",
            "license": "A054464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; 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.