Healthcare Provider Details

I. General information

NPI: 1659457075
Provider Name (Legal Business Name): UDAY KUMAR MUKHERJEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 OAK RD STE 270
WALNUT CREEK CA
94597-2078
US

IV. Provider business mailing address

3100 OAK RD STE 270
WALNUT CREEK CA
94597-2078
US

V. Phone/Fax

Practice location:
  • Phone: 925-944-9711
  • Fax: 925-944-9709
Mailing address:
  • Phone: 925-944-9711
  • Fax: 925-944-9709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberA081816
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA081816
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: