Provider Demographics
NPI:1003158585
Name:TRIPATHI, MUKTI
Entity Type:Individual
Prefix:
First Name:MUKTI
Middle Name:
Last Name:TRIPATHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 RED HAWK CIR
Mailing Address - Street 2:APARTMENT P206
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-4747
Mailing Address - Country:US
Mailing Address - Phone:210-667-8089
Mailing Address - Fax:
Practice Address - Street 1:975 KIRMAN AVE # 111
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-0993
Practice Address - Country:US
Practice Address - Phone:775-328-1429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program