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General NPI Number Information
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NPI Number | 1700949872
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Entity Type | Individual
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Provider Name | KANNAPPAN MOHAN MD
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Gender | Male
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 583 WEST PUTNAM AVENUE
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City | PORTERVILLE
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State | CA
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Zip | 93257-3260
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Country | US
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Telephone | 559-781-6655
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Fax | 559-781-7876
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Provider Business Mailing Address
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Address Line | 583 WEST PUTNAM AVENUE
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City | PORTERVILLE
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State | CA
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Zip | 93257-3260
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Country | US
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Telephone | 559-781-6655
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Fax | 559-781-7876
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C42107
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | C42107
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License Number State | CA
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