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General NPI Number Information
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NPI Number | 1629198171
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Entity Type | Individual
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Provider Name | KAVITHA MOTHKURI MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4 BLAZING STAR
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City | IRVINE
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State | CA
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Zip | 92604-3036
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Country | US
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Telephone | 949-651-6370
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Fax |
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Provider Business Mailing Address
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Address Line | 4 BLAZING STAR
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City | IRVINE
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State | CA
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Zip | 92604-3036
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Country | US
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Telephone | 949-651-6370
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Fax |
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | A96430
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | A96430
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A96430
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 281P00000X
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Taxonomy Name | Chronic Disease Hospital
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License Number | A96430
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number | A96430
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | A96430
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | A96430
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | A96430
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License Number State | CA
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