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NPI Code Detail

MEDICARE: ARKA DUTTA MD

MEDICARE: ARKA DUTTA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician77148MN
22085R0202XDiagnostic Radiology Physician25MA12462900NJ
32085R0202XDiagnostic Radiology PhysicianA203661CA

General Provider Information

NPI Number : 1114480613
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARKA DUTTA MD
Provider Business Mailing Address
First Line : PO BOX 255228
Second Line :
City : SACRAMENTO
State : CA
Zip : 95865-5228
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 COFFEE RD
Second Line :
City : MODESTO
State : CA
Zip : 95355-4201
Country : US
Telephone Number : 209-550-4755
Fax Number : 209-521-3970
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2019
Last Update Date : 05/18/2026

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