Provider Demographics
NPI:1548479140
Name:KRISHNASWAMY, ARUNA (MD)
Entity type:Individual
Prefix:DR
First Name:ARUNA
Middle Name:
Last Name:KRISHNASWAMY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.BOX 2989
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-1989
Mailing Address - Country:US
Mailing Address - Phone:714-379-3221
Mailing Address - Fax:714-379-3211
Practice Address - Street 1:7955 WESTMINSTER BLVD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4001
Practice Address - Country:US
Practice Address - Phone:714-379-3221
Practice Address - Fax:714-379-3211
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50217207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A502170Medicaid
CAA50217OtherPHYSICIAN LICENSE
CA00A502170Medicaid
CAWA50217IMedicare PIN
CAA50217OtherPHYSICIAN LICENSE