KISHORE K. KALLURI (NPI# 1073517751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073517751 |
| Entity Type | Individual |
| Full Name | KISHORE K. KALLURI |
| Credential | M.D. |
| Practice Address |
600 Coffee Rd Modesto CA 95355-4201 |
| Practice Telephone | 2095241211 |
| Mailing Telephone | 2095241211 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2015-09-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
C53094 | CA | Allopathic & Osteopathic Physicians |
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
036103114 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
600 COFFEE RD |
| City | MODESTO |
| State | CA |
| Zip Code | 95355-4201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508405622 | Erica Corral-ruiz | Registered Nurse | 600 Coffee Rd, Modesto, CA 95355-4201 | 2020-01-06 |
| 1598324519 | Cierra Coffman | Physician Assistant | 600 Coffee Rd, Modesto, CA 95355-4201 | 2019-06-12 |
| 1053879932 | Anitha Choorakulam George | Nurse Practitioner | 600 Coffee Rd, Modesto, CA 95355-4201 | 2019-03-09 |
| 1154852994 | Simran Kaur Bains | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2017-03-23 |
| 1891246153 | Pacific Infectious Diseases, Inc. | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2016-10-20 |
| 1497108062 | Palvasha Shah | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355 | 2016-07-19 |
| 1861845430 | Bharati Meesala | Hospitalist | 600 Coffee Rd, Modesto, CA 95355-4201 | 2016-07-19 |
| 1376999672 | David William Lowry | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2016-05-05 |
| 1245692250 | Swathi S.b. Kari | Hospitalist | 600 Coffee Rd, Modesto, CA 95355-4201 | 2016-03-28 |
| 1376901728 | Bryan Chow | Anesthesiology | 600 Coffee Rd, Modesto, CA 95355-4201 | 2016-01-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211793 | I To I LLC | Optometrist | 3401 Oakdale Rd, Ste 525, Modesto, CA 95355 | 2020-09-25 |
| 1205443116 | Altwal and Shelat Dds Inc | Dentist | 1317 Oakdale Road, Suite 310, Modesto, CA 95355 | 2020-09-24 |
| 1184255911 | Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation | Clinic/Center | 3401 Oakdale Road, Suite 505, Modesto, CA 95355 | 2020-01-30 |
| 1487133856 | Natalie Vargas | Behavior Technician | 1317 Oakdale Road Suite 610, Modesto, CA 95355 | 2018-08-07 |
| 1871079152 | Jill H Fusia | Dietitian, Registered | 1404 Cordero Court, Modesto, CA 95355 | 2018-07-19 |
| 1043727514 | Emily Lauren Schaefer | Behavioral Analyst | 3425 Coffee Rd Ste C2, Modesto, CA 95355 | 2018-01-05 |
| 1376083691 | Hari Gnanasekeram, PC | Technician, Cardiology | 1303 Mable Avenu, Modesto, CA 95355 | 2017-03-06 |
| 1598139891 | Encompass Health Rehabilitation Hospital of Modesto, LLC | Rehabilitation Hospital | 1303 Mable Avenue, Modesto, CA 95355 | 2015-11-24 |
| 1013387844 | Diana Faith Kigenyi | Social Worker | 1225 Oakdale Road, Modesto, CA 95355 | 2015-10-06 |
| 1437530672 | Tzu Yi Wei | Acupuncturist | 2209 Coffee Road, Suite A, Modesto, CA 95355 | 2015-06-12 |
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| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740588680 | Yuqiang Ge | Internal Medicine | 305 E Granger Ave, Ste 202, Modesto, CA 95350 | 2011-03-01 |
| 1548223480 | Josephine R Baisac | Internal Medicine | 608 E Orangeburg Ave, Modesto, CA 95350-5513 | 2006-04-11 |
| 1558363739 | Kriengsak Itsara | Internal Medicine | 305 E Granger Ave, Ste 202, Modesto, CA 95350-4344 | 2005-06-01 |
| 1053654343 | Nadia Yousef | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2013-04-04 |
| 1770738825 | Ravikiran Vegasana | Internal Medicine | 608 E Orangeburg Ave, Modesto, CA 95350-5513 | 2008-11-17 |
| 1659537264 | Mark T. Fahlen, Md, Inc. A Professional Medical Corporation | Internal Medicine | 1400 Florida Ave, Suite 109, Modesto, CA 95350-4422 | 2008-08-03 |
| 1114063716 | Dennis Y. Wu | Internal Medicine | 4601 Dale Rd, Modesto, CA 95356-9718 | 2007-01-30 |
| 1609926427 | Mohit Shahani | Internal Medicine | 4601 Dale Rd, Modesto, CA 95356-9718 | 2007-01-12 |
| 1629161336 | Tong Sun | Internal Medicine | 305 E Granger Ave, Ste 202, Modesto, CA 95350-4345 | 2006-10-02 |
| 1033145800 | Ronak Chandrakant Shah | Internal Medicine | 600 Coffee Rd, Modesto, CA 95355-4201 | 2006-06-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.