Healthcare Provider Details

I. General information

NPI: 1952861015
Provider Name (Legal Business Name): JOHN ALEXANDER KUIPERS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2019
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 PIONEER LN
BISHOP CA
93514-2556
US

IV. Provider business mailing address

2874 N CARSON ST STE 300
CARSON CITY NV
89706-1683
US

V. Phone/Fax

Practice location:
  • Phone: 760-873-2623
  • Fax: 760-873-2626
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number20A24073
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: