Provider Demographics
NPI:1780706788
Name:VERNAL, RAUL ANDRES (MD)
Entity type:Individual
Prefix:DR
First Name:RAUL
Middle Name:ANDRES
Last Name:VERNAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:360 DARDANELLI LN
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1421
Mailing Address - Country:US
Mailing Address - Phone:408-374-4570
Mailing Address - Fax:408-374-5296
Practice Address - Street 1:360 DARDANELLI LN
Practice Address - Street 2:SUITE 2G
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1421
Practice Address - Country:US
Practice Address - Phone:408-374-4570
Practice Address - Fax:408-374-5296
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA25770207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24565Medicare UPIN
CA00A257700Medicare ID - Type UnspecifiedMEDICARE PROVIDER#