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General NPI Number Information
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NPI Number | 1588862478
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Entity Type | Individual
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Provider Name | VELLORE G KASTURI MD
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Gender | Female
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 1418 E MAIN ST STE 210
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City | SANTA MARIA
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State | CA
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Zip | 93454-4836
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Country | US
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Telephone | 805-928-3678
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Fax | 805-928-6408
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Provider Business Mailing Address
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Address Line | 2625 E DIVISADERO ST
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City | FRESNO
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State | CA
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Zip | 93721-1431
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Country | US
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Telephone | 559-443-2682
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Fax | 559-443-2681
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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 | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | A146393
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 23055
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A146393
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License Number State | CA
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