Healthcare Provider Details

I. General information

NPI: 1447154794
Provider Name (Legal Business Name): KASTURI MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9706 FAIR OAKS BLVD STE 185
FAIR OAKS CA
95628-7088
US

IV. Provider business mailing address

9706 FAIR OAKS BLVD STE 185
FAIR OAKS CA
95628-7088
US

V. Phone/Fax

Practice location:
  • Phone: 916-333-4906
  • Fax:
Mailing address:
  • Phone: 916-333-4906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number StateNULL

VIII. Authorized Official

Name: RADHIKA KASTURI
Title or Position: OFFICE MANAGER
Credential:
Phone: 916-333-4906