Provider Demographics
NPI:1154061612
Name:KALERU, THANMAI
Entity type:Individual
Prefix:
First Name:THANMAI
Middle Name:
Last Name:KALERU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:THANMAI
Other - Middle Name:
Other - Last Name:MASTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 741515
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-1515
Mailing Address - Country:US
Mailing Address - Phone:253-838-2400
Mailing Address - Fax:253-874-1782
Practice Address - Street 1:33501 1ST WAY S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6208
Practice Address - Country:US
Practice Address - Phone:253-838-2400
Practice Address - Fax:253-874-1782
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61691460207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine