Provider Demographics
NPI:1780009936
Name:HEMANT UPADHYAYA, M.D. INC.
Entity Type:Organization
Organization Name:HEMANT UPADHYAYA, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HEMANT
Authorized Official - Middle Name:B
Authorized Official - Last Name:UPADHYAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-799-7127
Mailing Address - Street 1:1941 HUNTINGTON DR STE C
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-4994
Mailing Address - Country:US
Mailing Address - Phone:626-799-7127
Mailing Address - Fax:626-799-7570
Practice Address - Street 1:1941 HUNTINGTON DR STE C
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-4994
Practice Address - Country:US
Practice Address - Phone:626-799-7127
Practice Address - Fax:626-799-7570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44897208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty