Provider Demographics
NPI:1629079215
Name:NADGIR, ULHAS MAHABALA (MD)
Entity Type:Individual
Prefix:MR
First Name:ULHAS
Middle Name:MAHABALA
Last Name:NADGIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3814 AUBURN BLVD
Mailing Address - Street 2:SUITE 72
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-2123
Mailing Address - Country:US
Mailing Address - Phone:916-426-1902
Mailing Address - Fax:916-426-1940
Practice Address - Street 1:3814 AUBURN BLVD
Practice Address - Street 2:SUITE 72
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-2123
Practice Address - Country:US
Practice Address - Phone:916-426-1902
Practice Address - Fax:916-426-1940
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC512632080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C512630Medicaid
CA00C512630Medicaid
CAZZZ00663ZMedicare ID - Type Unspecified