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Organization
KRISHNA J MOHAN M D INC
Active
Organization
KRISHNA J MOHAN M D INC
Active
Parent organization
KRISHNA J MOHAN M D INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KRISHNA J MOHAN M D INC
Authorized official
KRISHNA JATAVALLABHULA MOHAN MD (MEDICAL DIRECTOR)
(626) 331-0175
Entity
Organization
Contact information
Practice address
171 W COTTAGE DR, COVINA, CA 91723-2010
(626) 331-0175
(626) 967-3849
Mailing address
171 W COTTAGE STREET, COVINA, CA 91723
(626) 331-0175
(626) 967-3849
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A341750
MEDI-CAL
CA
Enumeration date
09/20/2006
Last updated
08/18/2022
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