| Doctor Name: | DR. RAVI S PANJABI |
| NPI Number: | 1225024219 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | A55600 |
| Business Practice Address: | 19850 Lake Chabot Rd Castro Valley, CA - 94546 |
| Business Phone Number: | 5105828555 |
| Business Fax Number: | 5105818686 |
| Mailing Address: | 19850 Lake Chabot Rd, CASTRO VALLEY |
| State: | CA |
| Postal Code: | 945464002 |
| Phone Number: | 5105828555 |
| Fax Number: | 5105818686 |
| NPI Enumeration Date: | 09/23/2005 |
| NPI Last Update Date: | 10/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 03/24/2006 |
| NPI Reactivation Date: | 11/09/2006 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | A55600 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |