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General NPI Number Information
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NPI Number | 1316495781
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Entity Type | Organization
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Legal Business Name | LAVANYA KRISHNAN MD, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 459 GEARY ST STE 400
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-1275
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Country | US
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Telephone | 415-329-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 459 GEARY ST STE 400
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-1275
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Country | US
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Telephone | 415-329-5100
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Fax |
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Authorized Official
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Title or Position | C.E.O.
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Name | DR. LAVANYA KRISHNAN
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Credential | M.D.
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Telephone | 415-329-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A130272
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License Number State | CA
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