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NPI Code Detail

MEDICARE: SRIDHARAN RADHAKRISHNAN MD

MEDICARE: SRIDHARAN RADHAKRISHNAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2208600000XSurgery Physician17364CA

General Provider Information

NPI Number : 1477283778
Entity Type Code : Individual
Provider Name (Legal Business Name) : SRIDHARAN RADHAKRISHNAN MD
Provider Business Mailing Address
First Line : 3800 W CHAPMAN AVE STE 6200
Second Line :
City : ORANGE
State : CA
Zip : 92868-1640
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3800 W CHAPMAN AVE STE 6200
Second Line :
City : ORANGE
State : CA
Zip : 92868-1640
Country : US
Telephone Number : 714-456-7890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2022
Last Update Date : 08/09/2025

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Directions to “ SRIDHARAN RADHAKRISHNAN MD” Practice Location

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