Individual
KRISHNA JATAVALLABHULA MOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
158 W COLLEGE ST, COVINA, CA 91723
(626) 331-0175
(626) 967-3849
Mailing address
158 W COLLEGE ST, COVINA, CA 91723
(626) 331-0175
(626) 967-3849
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A34175
CA
207RN0300X
Nephrology Physician
Primary
A34175
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A341750
—
CA
Enumeration date
09/28/2006
Last updated
08/16/2011
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