Provider Demographics
NPI:1316263759
Name:KRISHNAN, LAVANYA PARACHURU (MD)
Entity type:Individual
Prefix:MRS
First Name:LAVANYA
Middle Name:PARACHURU
Last Name:KRISHNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:LAVANYA
Other - Middle Name:
Other - Last Name:PARACHURU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:459 GEARY ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1273
Mailing Address - Country:US
Mailing Address - Phone:415-329-5100
Mailing Address - Fax:415-964-5553
Practice Address - Street 1:459 GEARY ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1273
Practice Address - Country:US
Practice Address - Phone:415-329-5100
Practice Address - Fax:415-964-5553
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2016-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA130272207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology