Provider Demographics
NPI:1285725945
Name:KRISHNA, DODDANNA (M D)
Entity type:Individual
Prefix:
First Name:DODDANNA
Middle Name:
Last Name:KRISHNA
Suffix:
Gender:
Credentials:M D
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:44215 15TH STREET WEST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534
Mailing Address - Country:US
Mailing Address - Phone:661-726-6600
Mailing Address - Fax:661-726-6603
Practice Address - Street 1:44215 15TH STREET WEST
Practice Address - Street 2:SUITE 211
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534
Practice Address - Country:US
Practice Address - Phone:661-726-6600
Practice Address - Fax:661-726-6603
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA43598207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA43598OtherCALIFORNIA MEDICAL LICENSE
CAE07467Medicare UPIN