Provider Demographics
NPI:1932162815
Name:CHUNDRU, SRIKRISHNA (MD)
Entity Type:Individual
Prefix:DR
First Name:SRIKRISHNA
Middle Name:
Last Name:CHUNDRU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10825 E KESWICK RD
Mailing Address - Street 2:APT 236
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-4134
Mailing Address - Country:US
Mailing Address - Phone:215-821-1163
Mailing Address - Fax:360-252-7131
Practice Address - Street 1:1771 W ROMNEYA DR
Practice Address - Street 2:SUITE - C
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1817
Practice Address - Country:US
Practice Address - Phone:714-520-3000
Practice Address - Fax:714-520-5742
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92748207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine