Healthcare Provider Details
I. General information
NPI: 1891158200
Provider Name (Legal Business Name): KRISHNA PUNDI
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/02/2016
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 PASTEUR DR
STANFORD CA
94305-2200
US
IV. Provider business mailing address
300 PASTEUR DR
STANFORD CA
94305-2200
US
V. Phone/Fax
- Phone: 650-723-4000
- Fax: 650-498-6205
- Phone: 650-723-4000
- Fax: 650-498-6205
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | A150907 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | A150907 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | A150907 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: