Healthcare Provider Details

I. General information

NPI: 1194528752
Provider Name (Legal Business Name): KHEMRAJ RUPEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 DOLBEER ST
EUREKA CA
95501-4736
US

IV. Provider business mailing address

9574 115TH ST
SOUTH RICHMOND HILL NY
11419-1126
US

V. Phone/Fax

Practice location:
  • Phone: 707-445-8121
  • Fax: 707-269-7116
Mailing address:
  • Phone: 718-925-7615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: