KRISHNAMOORTHI MD INC. (NPI# 1316098205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316098205 |
| Entity Type | Organization |
| Organization Name | KRISHNAMOORTHI MD INC. |
| Practice Address |
324 F St Waterford CA 95386-9013 |
| Practice Telephone | 2098742321 |
| Practice Fax Number | 2098743896 |
| Mailing Telephone | 2098742321 |
| Mailing Fax Number | 2098743896 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-07-10 |
| Authorized Official Name | DR. KRISHNAMOORTHI KRISHNAMOORTHI (CEO) |
| Authorized Official Telephone | 2098742321 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A708970 | 05 | |
| CA | RHM53829H | 05 |
| Street Address |
324 F ST |
| City | WATERFORD |
| State | CA |
| Zip Code | 95386-9013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588762538 | Krishnamoorthi Krishnamoorthi | Internal Medicine | 324 F St, Waterford, CA 95386-9013 | 2006-09-20 |
| 1417329640 | Agatha John | Family Medicine | 324 F St, Waterford, CA 95386-9013 | 2015-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366857658 | Diana Hollingshead-parker | Registered Nurse | 421 Tim Bell Rd, Waterford, CA 95386 | 2014-06-25 |
| 1497817407 | James Yamamoto | Dentist | 12142 Yosemite Blvd, Waterford, CA 95386 | 2006-12-15 |
| 1588664684 | Don Michael Endress | General Practice | 12700 Welch St, Waterford, CA 95386-8765 | 2005-07-29 |
| 1649527664 | Eric Gust Benson | Registered Nurse | 12700 Welch St, Waterford, CA 95386-8765 | 2012-08-08 |
| 1326106501 | Don Michael Endress M.d. | General Practice | 12700 Welch St, Waterford, CA 95386-8765 | 2006-12-04 |
| 1356686992 | Kimberlie Ann Payne | Occupational Therapy Assistant | 13209 Fountain Dr, Waterford, CA 95386-8858 | 2012-12-08 |
| 1518423631 | Gill Pharmacy Inc | Pharmacy | 12648 Bentley St, Waterford, CA 95386-9009 | 2019-02-13 |
| 1639709520 | Ravi Gandhi | Pharmacy | 12648 Bentley St, Waterford, CA 95386-9009 | 2020-01-20 |
| 1528433588 | Livingston Community Health | Clinic/Center | 12619 Bentley St, Waterford, CA 95386-9011 | 2015-12-02 |
| 1336176122 | Maximilian A. Schanderl | Pharmacist | 12641 Bentley St, Waterford, CA 95386-9011 | 2006-06-27 |
| Find all providers in zip 95386 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881030401 | Oak Valley Hospital District | Clinic/Center | 12146 Yosemite Blvd, Waterford, CA 95386-9163 | 2013-05-22 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.