Provider Demographics
NPI:1598957540
Name:CHANDURI, KRISHI (MD)
Entity type:Individual
Prefix:
First Name:KRISHI
Middle Name:
Last Name:CHANDURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:840 TOWNE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-5900
Mailing Address - Country:US
Mailing Address - Phone:909-398-1550
Mailing Address - Fax:909-398-1488
Practice Address - Street 1:138 HARVARD AVE
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4716
Practice Address - Country:US
Practice Address - Phone:909-624-4503
Practice Address - Fax:909-624-6364
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2020-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA106301207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine