Organization
KRISHNAMOORTHI MD INC A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISHNAMOORTHI KRISHNAMOORTHI (DOCTOR)
(209) 874-2321
Entity
Organization
Contact information
Practice address
324 F ST, WATERFORD, CA 95386-9013
(209) 874-2321
(209) 874-3896
Mailing address
324 F ST, WATERFORD, CA 95386-9013
(209) 609-6629
(209) 874-3896
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A708970
—
CA
05
—
RHM53829H
—
CA
Enumeration date
01/16/2007
Last updated
02/06/2026
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