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General NPI Number Information
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NPI Number | 1780009936
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Entity Type | Organization
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Legal Business Name | HEMANT UPADHYAYA, M.D. INC.
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Dates
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Enumeration Date | 02/25/2014
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Last Update Date | 02/25/2014
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Provider Practice Location Address
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Address Line | 1941 HUNTINGTON DR STE C
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-4994
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Country | US
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Telephone | 626-799-7127
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Fax | 626-799-7570
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Provider Business Mailing Address
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Address Line | 1941 HUNTINGTON DR STE C
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-4994
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Country | US
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Telephone | 626-799-7127
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Fax | 626-799-7570
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Authorized Official
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Title or Position | OWNER / PHYSICIAN
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Name | HEMANT B UPADHYAYA
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Credential | M.D.
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Telephone | 626-799-7127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A44897
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License Number State | CA
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