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NPI Code Detail

MEDICARE: MADAN MUKHOPADHYAY M.D.

MEDICARE: MADAN MUKHOPADHYAY M.D.
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
1174400000XSpecialistA32177CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A32177OTHERCALICENSE

General Provider Information

NPI Number : 1912994542
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADAN MUKHOPADHYAY M.D.
Provider Business Mailing Address
First Line : 6020 DE LA GUERRA TER
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93306-9754
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6501 TRUXTUN AVE
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93309-0633
Country : US
Telephone Number : 661-322-2206
Fax Number : 661-327-7027
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2005
Last Update Date : 10/05/2010

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