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General NPI Number Information
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NPI Number | 1629196282
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Entity Type | Individual
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Provider Name | KAVITHA KRISHNAMANI M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 3815 E BELL RD STE 4100
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City | PHOENIX
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State | AZ
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Zip | 85032-2167
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Country | US
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Telephone | 602-633-3848
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Fax | 602-633-3841
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Provider Business Mailing Address
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Address Line | 3815 E BELL RD STE 2200
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City | PHOENIX
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State | AZ
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Zip | 85032-2139
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Country | US
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Telephone | 602-633-3848
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Fax | 602-633-3841
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00047733
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | ML20008124
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 59825
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License Number State | AZ
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