Basic Information
| Provider Information | |||||||||
| NPI: | 1568403210 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KRISHNAN | ||||||||
| FirstName: | ARUN | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 255228 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958655228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004700071 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2801 K ST | ||||||||
| Address2: | SUITE 502 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958165120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167334400 | ||||||||
| FaxNumber: | 9164546926 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2006 | ||||||||
| LastUpdateDate: | 07/06/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085N0700X | 046145 | GA | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085N0700X | C54527 | CA | Y | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology |
No ID Information.