Provider Demographics
NPI:1871797209
Name:UMAPATHY, KRISHNAMURTHY (MD)
Entity type:Individual
Prefix:
First Name:KRISHNAMURTHY
Middle Name:
Last Name:UMAPATHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 MONTESE CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2202
Mailing Address - Country:US
Mailing Address - Phone:503-758-3780
Mailing Address - Fax:
Practice Address - Street 1:2117 MONTESE CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2202
Practice Address - Country:US
Practice Address - Phone:503-758-3780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA113119207RC0200X
ORMD27497207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR006269Medicaid
OR006269Medicaid