Provider Demographics
NPI:1487656021
Name:RUGAMA, ARNOLD (MD)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:
Last Name:RUGAMA
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 28915
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-8915
Mailing Address - Country:US
Mailing Address - Phone:559-840-2262
Mailing Address - Fax:559-253-2808
Practice Address - Street 1:1660 E HERNDON AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3346
Practice Address - Country:US
Practice Address - Phone:559-840-2262
Practice Address - Fax:559-253-2808
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA603350207QS1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A633500Medicaid
CA00A633500Medicaid
00A633500Medicare ID - Type Unspecified