| Krishnamoorthi M.d. Inc. | |
|
2222 E Orangeburg Ave Suite A2 Modesto CA 95355-3399 | |
| (209) 622-0877 | |
| (209) 622-0956 |
| Full Name | Krishnamoorthi M.d. Inc. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2222 E Orangeburg Ave, Modesto, California |
| Authorized Official Name and Position | Krishnamoorthi Krishnamoorthi (CEO) |
| Authorized Official Contact | 2096220877 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Krishnamoorthi M.d. Inc. 2222 E Orangeburg Ave Suite A2 Modesto CA 95355-3399 Ph: (209) 622-0877 | Krishnamoorthi M.d. Inc. 2222 E Orangeburg Ave Suite A2 Modesto CA 95355-3399 Ph: (209) 622-0877 |
| NPI Number | 1528119435 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 11/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528119435 | NPI | - | NPPES |
| GR0104660 | Medicaid | CA | |
| PA20513 | Other | CA | CO676Z |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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