# KRISHNAMOORTHI MD INC A PROFESSIONAL MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316098205
- **Authorized official:** DR. KRISHNAMOORTHI KRISHNAMOORTHI (DOCTOR)
- **Authorized official phone:** (209) 874-2321

## Contact information

- **Practice address:** 324 F ST, WATERFORD, CA 95386-9013
- **Practice address phone:** (209) 874-2321
- **Practice address fax:** (209) 874-3896
- **Mailing address:** 324 F ST, WATERFORD, CA 95386-9013
- **Mailing address phone:** (209) 609-6629
- **Mailing address fax:** (209) 874-3896

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/16/2007
- **Last updated:** 02/06/2026