Individual
DR. JAYANTHI IDURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4601 DALE RD, KAISER PERMANENTE, MODESTO, CA 95356-9718
(925) 577-1489
Mailing address
4601 DALE RD, KAISER PERMANENETE, MODESTO, CA 95356-9718
(925) 577-1489
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
A106098
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/02/2009
Last updated
02/11/2022
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