Healthcare Provider Details

I. General information

NPI: 1245659457
Provider Name (Legal Business Name): RUCHI PUNATAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 EUREKA RD
ROSEVILLE CA
95661-3027
US

IV. Provider business mailing address

1600 EUREKA RD BLDG C
ROSEVILLE CA
95661-3027
US

V. Phone/Fax

Practice location:
  • Phone: 916-474-2250
  • Fax:
Mailing address:
  • Phone: 916-474-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA140033
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: