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General NPI Number Information
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NPI Number | 1639969900
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Entity Type | Individual
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Provider Name | RUPINDERPAL S MANGAT
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Gender | Male
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 2615 E CLINTON AVE
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City | FRESNO
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State | CA
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Zip | 93703-2223
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Country | US
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Telephone | 559-225-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 11253 N VIA PALERMO WAY
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City | FRESNO
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State | CA
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Zip | 93730-8818
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Country | US
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Telephone | 559-403-3708
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 752554
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License Number State | CA
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