Provider Demographics
NPI:1326084419
Name:UPPAL, HARTEJ SINGH (MD)
Entity Type:Individual
Prefix:
First Name:HARTEJ
Middle Name:SINGH
Last Name:UPPAL
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 1:2161 SUNSET BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-4792
Mailing Address - Country:US
Mailing Address - Phone:916-538-7272
Mailing Address - Fax:888-552-5615
Practice Address - Street 1:2161 SUNSET BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-4792
Practice Address - Country:US
Practice Address - Phone:916-538-7272
Practice Address - Fax:888-552-5615
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78671207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A786710Medicaid
D00079998OtherRAILROAD MEDICARE
CA00A786711Medicare ID - Type Unspecified
D00079998OtherRAILROAD MEDICARE