Provider Demographics
NPI:1689729527
Name:BHUPATHY, VELLORE RAJABATHER (MD)
Entity Type:Individual
Prefix:
First Name:VELLORE
Middle Name:RAJABATHER
Last Name:BHUPATHY
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 1:14350 E WHITTIER BLVD SUITE 205
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2138
Mailing Address - Country:US
Mailing Address - Phone:562-945-3707
Mailing Address - Fax:562-945-0120
Practice Address - Street 1:14350 E WHITTIER BLVD SUITE 205
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2138
Practice Address - Country:US
Practice Address - Phone:562-945-3707
Practice Address - Fax:562-945-0120
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA264410207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A264410Medicaid
A24838Medicare UPIN