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RAVEEN THEKKEURIMBIL RAVIENDRAN M.D. NPI 1700081080


NPI Information

NPI: 1700081080
Provider Name: RAVEEN THEKKEURIMBIL RAVIENDRAN, M.D.
Classification: Pediatrics - 2080P0203X
Entity Type: Individual

Specialization: Pediatric Critical Care Medicine

PECOS Registration: Yes

Address:
3626 RUFFIN RD
SAN DIEGO, CA
ZIP 92123
Phone: (858) 565-9666
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Raveen Thekkeurimbil Raviendran, M.D. is a pediatric critical care medicine pediatrics in San Diego, CA. The provider is a pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. Raveen Thekkeurimbil Raviendran, M.D. NPI is 1700081080. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3626 RUFFIN RD
SAN DIEGO, CA
ZIP 92123-810
Phone: (858) 565-9666
Fax: (858) 565-9441

The NPI 1700081080 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/18/2007 and was last updated on 8/22/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsA 108610CALIFORNIANo
22080P0203XPediatricsPediatric Critical Care MedicineA 108610CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11700081080MEDICAIDCALIFORNIA
2EG958YMEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.