Provider Demographics
NPI:1417076738
Name:CHEEMA, RUPINDER K (MD)
Entity Type:Individual
Prefix:
First Name:RUPINDER
Middle Name:K
Last Name:CHEEMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RUPI
Other - Middle Name:
Other - Last Name:CHEEMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3001 DOUGLAS BLVD., SUITE 325
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661
Mailing Address - Country:US
Mailing Address - Phone:916-241-9844
Mailing Address - Fax:
Practice Address - Street 1:3001 DOUGLAS BLVD STE 325
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4289
Practice Address - Country:US
Practice Address - Phone:916-241-9844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98385207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAP595ZMedicare PIN
CA00A983850Medicare PIN