CHETAN K POTU - NPI 1104575661 - Student in an Organized Health Care Education/Training Program in San Jose, CA

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

On this page

About Chetan K Potu NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHETAN K POTU (NPI 1104575661) is an individual student in an organized health care education/training program in San Jose, California and active in the NPI registry since March 2022.

NPPES Registry Identity

NPI1104575661

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameCHETAN K POTU

Location Address751 S BASCOM AVESan Jose, CA 95128-2699

Mailing Address450 Broadway StRedwood City, CA 94063-3132 · (650) 721-7669

Phone(631) 689-8333

Sole ProprietorYes

Enumeration DateMarch 22, 2022

Last NPPES UpdateJanuary 14, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 14, 2026

✔ NPI 1104575661 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

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.

751 S BASCOM AVE, San Jose, CA 95128

Open in Google Maps ↗