Provider Demographics
NPI:1174351100
Name:KAYASTHA, GYAN KRISHNA (MD)
Entity type:Individual
Prefix:DR
First Name:GYAN
Middle Name:KRISHNA
Last Name:KAYASTHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TOWPATH DR
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3524
Mailing Address - Country:US
Mailing Address - Phone:520-369-4031
Mailing Address - Fax:
Practice Address - Street 1:49169 ROAD 426
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:CA
Practice Address - Zip Code:93644-8702
Practice Address - Country:US
Practice Address - Phone:559-664-4000
Practice Address - Fax:559-479-4812
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301512448207R00000X
CAA200867207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine