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General NPI Number Information
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NPI Number | 1124022819
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Entity Type | Individual
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Provider Name | KRISHNA M PINNAMANENI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1847 E SOUTHERN AVE STE 1
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City | TEMPE
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State | AZ
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Zip | 85282-5881
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Country | US
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Telephone | 480-838-2277
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Fax | 480-838-3887
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Provider Business Mailing Address
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Address Line | 1847 E SOUTHERN AVE STE 1
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City | TEMPE
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State | AZ
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Zip | 85282-5881
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Country | US
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Telephone | 480-838-2277
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Fax | 480-838-3887
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 14173
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License Number State | AZ
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