Individual
DR. KALYAN KOSURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 569-7408
(209) 491-7587
Mailing address
10470 OLD PLACERVILLE RD STE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301085571
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
A112973
CA
207RP1001X
Pulmonary Disease Physician
A112973
CA
Other
Enumeration date
04/04/2007
Last updated
09/12/2019
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