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General NPI Number Information
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NPI Number | 1992760763
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Entity Type | Individual
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Provider Name | PRASANNA L. KRISHNAMSHETTY M.D
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Gender | Female
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 200 JOSE FIGUERES AVE STE# 435
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City | SAN JOSE
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State | CA
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Zip | 95116-1500
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Country | US
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Telephone | 408-258-4244
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Fax | 408-258-3338
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Provider Business Mailing Address
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Address Line | 200 JOSE FIGUERES AVE STE# 435
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City | SAN JOSE
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State | CA
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Zip | 95116-1500
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Country | US
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Telephone | 408-258-4244
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Fax | 408-258-3338
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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 | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | A63379
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License Number State | CA
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