Healthcare Provider Details

I. General information

NPI: 1154380343
Provider Name (Legal Business Name): PUSHPALATHA V ARAKERE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7035 N MAPLE AVE SUIT-101
FRESNO CA
93720-8015
US

IV. Provider business mailing address

7035 N MAPLE AVE SUIT-101
FRESNO CA
93720-8015
US

V. Phone/Fax

Practice location:
  • Phone: 559-323-4987
  • Fax: 559-323-1833
Mailing address:
  • Phone: 559-323-4987
  • Fax: 559-323-1833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA88072
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: