Organization
S. KRISHNAN MD INC
Active
Other names
SUBBARAYAN KRISHNAN MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUBBARAYAN KRISHNAN M.D. (OWNER)
(951) 766-7030
Entity
Organization
Contact information
Practice address
1031 E LATHAM AVE, #3, HEMET, CA 92543-4425
(951) 766-7030
(951) 766-5800
Mailing address
1031 E LATHAM AVE, #3, HEMET, CA 92543-4425
(951) 766-7030
(951) 766-5800
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A054481
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A544810
MEDICARE PTAN
CA
01
—
1023047198 01
MEDI-CAL PROVIDER NUMBER
CA
05
—
4882835
—
CA
Enumeration date
08/30/2010
Last updated
08/30/2010
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