Provider Demographics
NPI:1184805335
Name:SETTY, KIRAN N
Entity type:Individual
Prefix:
First Name:KIRAN
Middle Name:N
Last Name:SETTY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:KIRAN
Other - Middle Name:N
Other - Last Name:SETTY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:1000 W BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4139
Mailing Address - Country:US
Mailing Address - Phone:323-720-9300
Mailing Address - Fax:
Practice Address - Street 1:1000 W BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4139
Practice Address - Country:US
Practice Address - Phone:323-720-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4739213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABC286ZMedicare PIN
CA6244020001Medicare NSC