Provider Demographics
NPI:1295837557
Name:PAD S.KRISHNA MD INC
Entity Type:Organization
Organization Name:PAD S.KRISHNA MD INC
Other - Org Name:PAD KRISHNA MD
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAD
Authorized Official - Middle Name:S
Authorized Official - Last Name:KRISHNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACC
Authorized Official - Phone:562-531-7757
Mailing Address - Street 1:3650 E SOUTH ST
Mailing Address - Street 2:SUITE 411
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-1512
Mailing Address - Country:US
Mailing Address - Phone:562-531-7757
Mailing Address - Fax:562-531-0833
Practice Address - Street 1:3650 SOUTH ST
Practice Address - Street 2:SUITE #411
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-1502
Practice Address - Country:US
Practice Address - Phone:562-531-7757
Practice Address - Fax:562-531-0833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30918207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A84147Medicare UPIN
CA0656920001Medicare NSC
CAWA33106AMedicare PIN
CAW8791Medicare ID - Type Unspecified
CAWA30918AMedicare PIN