Provider Demographics
NPI:1669487112
Name:KRISHNAPRIYAN, GEETA (MD)
Entity Type:Individual
Prefix:
First Name:GEETA
Middle Name:
Last Name:KRISHNAPRIYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 GRANT RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-3855
Mailing Address - Country:US
Mailing Address - Phone:408-736-6841
Mailing Address - Fax:408-736-7329
Practice Address - Street 1:2204 GRANT RD
Practice Address - Street 2:SUITE 203
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-3855
Practice Address - Country:US
Practice Address - Phone:408-736-6841
Practice Address - Fax:408-736-7329
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC050043207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC0500430Medicaid
CAC0500430Medicaid
C050043Medicare ID - Type Unspecified