Organization
KRISHNAMOORTHI MD INC A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISHNAMOORTHI KRISHNAMOORTHI M.D. (CEO)
(209) 622-0877
Entity
Organization
Contact information
Practice address
2222 E ORANGEBURG AVE STE A2, MODESTO, CA 95355-3399
(209) 622-0877
(209) 622-0956
Mailing address
2222 E ORANGEBURG AVE STE A2, MODESTO, CA 95355-3399
(209) 622-0877
(209) 622-0956
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0104660
—
CA
01
—
PA20513
CO676Z
CA
Enumeration date
01/16/2007
Last updated
02/09/2026
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