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Individual

PHANI PURUSHOTHAM MORISETTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1801 E MARCH LN STE B265, STOCKTON, CA 95210-6655
(209) 546-1868
(209) 461-6505
Mailing address
1801 E MARCH LN STE B265, STOCKTON, CA 95210-6655
(209) 546-1868
(209) 461-6505

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
302690
LA
207RN0300X
Nephrology Physician
302690
LA
207RN0300X
Nephrology Physician
Primary
C184332
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/06/2013
Last updated
03/05/2023
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