Provider Demographics
NPI:1548318322
Name:KARUKONDA, SREE RAMA KRISHNA (MD)
Entity type:Individual
Prefix:
First Name:SREE
Middle Name:RAMA KRISHNA
Last Name:KARUKONDA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6399 SAN IGNACIO AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1215
Mailing Address - Country:US
Mailing Address - Phone:408-369-5620
Mailing Address - Fax:
Practice Address - Street 1:23451 MADISON ST STE 300
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4737
Practice Address - Country:US
Practice Address - Phone:310-375-9994
Practice Address - Fax:310-375-0789
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2021-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA64903207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology