Provider Demographics
NPI:1487842878
Name:VELLORE R BHUPATHY M D A P C
Entity Type:Organization
Organization Name:VELLORE R BHUPATHY M D A P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VELLORE
Authorized Official - Middle Name:RAJABATHER
Authorized Official - Last Name:BHUPATHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACOG
Authorized Official - Phone:562-945-3707
Mailing Address - Street 1:14350 E WHITTIER BLVD
Mailing Address - Street 2:#205
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605
Mailing Address - Country:US
Mailing Address - Phone:562-945-3707
Mailing Address - Fax:562-945-0120
Practice Address - Street 1:14350 E WHITTIER BLVD
Practice Address - Street 2:#205
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605
Practice Address - Country:US
Practice Address - Phone:562-945-3707
Practice Address - Fax:562-945-0120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA264410207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A264410Medicaid
CA00A264410Medicaid