Provider Demographics
NPI:1588447858
Name:JAYA KRISHNA CHINTANABOINA MD INCORPORATED
Entity type:Organization
Organization Name:JAYA KRISHNA CHINTANABOINA MD INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAYA KRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHINTANABOINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-438-8400
Mailing Address - Street 1:7405 N FRESNO STREET
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2457
Mailing Address - Country:US
Mailing Address - Phone:559-438-8400
Mailing Address - Fax:559-438-0477
Practice Address - Street 1:7405 N FRESNO STREET
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2457
Practice Address - Country:US
Practice Address - Phone:559-438-8400
Practice Address - Fax:559-438-0477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-18
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty