Provider Demographics
NPI:1174753222
Name:DR KISHU H NAGARANI MD INC
Entity type:Organization
Organization Name:DR KISHU H NAGARANI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KISHU
Authorized Official - Middle Name:H
Authorized Official - Last Name:NAGRANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-584-2229
Mailing Address - Street 1:460 GREENFIELD AVE STE 2A
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-3500
Mailing Address - Country:US
Mailing Address - Phone:559-584-2229
Mailing Address - Fax:559-584-5461
Practice Address - Street 1:460 GREENFIELD AVE STE 2A
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3500
Practice Address - Country:US
Practice Address - Phone:559-584-2229
Practice Address - Fax:559-584-5461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA344670302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization