Healthcare Provider Details

I. General information

NPI: 1497027809
Provider Name (Legal Business Name): KRISHNA AND NIRMALA MURTHY MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2012
Last Update Date: 01/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18523 CORWIN RD STE H
APPLE VALLEY CA
92307-2300
US

IV. Provider business mailing address

18523 CORWIN RD STE H
APPLE VALLEY CA
92307-2300
US

V. Phone/Fax

Practice location:
  • Phone: 760-242-3000
  • Fax: 760-242-1802
Mailing address:
  • Phone: 760-242-3000
  • Fax: 760-242-1802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA431240
License Number StateCA

VIII. Authorized Official

Name: DR. NIRMALA MURTHY
Title or Position: PRESIDENT
Credential: M.D
Phone: 760-242-3000