Provider Demographics
NPI:1215194873
Name:KULKARNI, MRINALINI (MD)
Entity Type:Individual
Prefix:
First Name:MRINALINI
Middle Name:
Last Name:KULKARNI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MRINALINI
Other - Middle Name:Y
Other - Last Name:GATHOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6720 BERTNER AVENUE
Mailing Address - Street 2:PO BOX 72
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77498
Mailing Address - Country:US
Mailing Address - Phone:209-468-6600
Mailing Address - Fax:209-468-7042
Practice Address - Street 1:6720 BERTNER ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2604
Practice Address - Country:US
Practice Address - Phone:209-468-6600
Practice Address - Fax:209-468-7042
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102509207R00000X
TXN9725208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFG0794645OtherDEA