Healthcare Provider Details

I. General information

NPI: 1841430758
Provider Name (Legal Business Name): SANTHI KANURI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2009
Last Update Date: 10/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 H ST SUITE F
BAKERSFIELD CA
93301-1900
US

IV. Provider business mailing address

2828 H ST SUITE F
BAKERSFIELD CA
93301-1900
US

V. Phone/Fax

Practice location:
  • Phone: 661-325-2015
  • Fax:
Mailing address:
  • Phone: 661-325-2015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA105401
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: