Individual provider · Type 1 NPI

Chetan K. Potu

Student in an Organized Health Care Education/Training Program · San Jose, CA

NPI number 1104575661 Active

Practice location

751 S Bascom Ave
San Jose, CA 95128-2699

Call (631) 689-8333 Map

Mailing address

450 Broadway St
Redwood City, CA 94063-3132

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1104575661

Chetan K. Potu's National Provider Identifier is 1104575661, issued on Mar 22, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in San Jose, CA. The record was last updated on Jan 14, 2026.