Provider Demographics
NPI:1063629962
Name:GULATI, ISH KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:ISH
Middle Name:KUMAR
Last Name:GULATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60128
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93386-0128
Mailing Address - Country:US
Mailing Address - Phone:661-412-4785
Mailing Address - Fax:661-381-7374
Practice Address - Street 1:3700 PARTERRE CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9933
Practice Address - Country:US
Practice Address - Phone:661-412-4785
Practice Address - Fax:661-381-7374
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0942682080N0001X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3156650Medicaid