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General NPI Number Information
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NPI Number | 1649318023
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Entity Type | Individual
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Provider Name | CHANDRA KANTH KATIKIREDDY M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 06/13/2014
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Provider Practice Location Address
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Address Line | 2210 E ILLINOIS AVE SUITE 508
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City | FRESNO
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State | CA
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Zip | 93701-2125
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Country | US
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Telephone | 559-320-0545
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Fax | 559-320-0550
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | A82981
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Internal Medicine Physician
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License Number | A82981
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | A82981
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number | A82981
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A82981
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License Number State | CA
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