Provider Demographics
NPI:1215043997
Name:KOTA, GUNNAYYA CHETTY (MD)
Entity Type:Individual
Prefix:DR
First Name:GUNNAYYA CHETTY
Middle Name:
Last Name:KOTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KOTA
Other - Middle Name:G
Other - Last Name:CHETTY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6831 PRESIDENTE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-3024
Mailing Address - Country:US
Mailing Address - Phone:714-960-3805
Mailing Address - Fax:
Practice Address - Street 1:6831 PRESIDENTE DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-3024
Practice Address - Country:US
Practice Address - Phone:714-960-3805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25735207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease