| Krishnamoorthi M. D. Inc., A Professional Medical Corporation | |
|
324 F St Waterford CA 95386-9013 | |
| (209) 874-2321 | |
| (209) 874-3896 |
| Full Name | Krishnamoorthi M. D. Inc., A Professional Medical Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 324 F St, Waterford, California |
| Authorized Official Name and Position | Krishnamoorthi Krishnamoorthi (CEO) |
| Authorized Official Contact | 2098742321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Krishnamoorthi M. D. Inc., A Professional Medical Corporation 324 F St Waterford CA 95386-9013 Ph: (209) 874-2321 | Krishnamoorthi M. D. Inc., A Professional Medical Corporation 324 F St Waterford CA 95386-9013 Ph: (209) 874-2321 |
| NPI Number | 1316098205 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 03/22/2022 |
| Medicare PECOS PAC ID | 1153323324 |
|---|---|
| Medicare Enrollment ID | O20070201000488 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316098205 | NPI | - | NPPES |
| 00A708970 | Medicaid | CA | |
| RHM53829H | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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