Healthcare Provider Details

I. General information

NPI: 1083325625
Provider Name (Legal Business Name): ISH GULATI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 PARTERRE CT
BAKERSFIELD CA
93311-9933
US

IV. Provider business mailing address

PO BOX 60128
BAKERSFIELD CA
93386-0128
US

V. Phone/Fax

Practice location:
  • Phone: 661-412-4785
  • Fax: 661-381-7374
Mailing address:
  • Phone: 661-412-4785
  • Fax: 661-381-7374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ISH GULATI
Title or Position: PRESIDENT
Credential:
Phone: 216-571-9480