KRISHNAMOORTHI M.D. INC. NPI 1528119435

NPI Information

  • NPI: 1528119435
  • Provider Name: KRISHNAMOORTHI M.D. INC.
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 05D0989666
  • Address: 2222 E ORANGEBURG AVE
    SUITE A2
    MODESTO, CA
    ZIP 95355
  • Phone: (209) 622-0877

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NPI Details

KRISHNAMOORTHI M.D. INC. is a primary care clinic center in Modesto, CA. KRISHNAMOORTHI M.D. INC. NPI is 1528119435. The provider is registered as an organization entity type.

The provider's business location address is:

2222 E ORANGEBURG AVE
SUITE A2
MODESTO, CA
ZIP 95355-399
Phone: (209) 622-0877
Fax: (209) 622-0956

The provider's authorized official is Krishnamoorthi Krishnamoorthi .
The authorized official title is Ceo and has the following contact phone number (209) 622-0877.

The CLIA number assigned to this NPI record is 05D0989666 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 11/16/2010.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1ZZZ04426ZMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAMCR GROUP ID
2PA20513OTHERCALIFORNIACO676Z
300A708970MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAK. KRISHNAMOORTHI, MD ID
4GR0104660MEDICAIDCALIFORNIA
500A765620MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIASOMA KRISHNAMOORTHI MD ID

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: 3/30/2025

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