Provider Demographics
NPI:1780647750
Name:JAGPAL, KULDEEP SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:KULDEEP
Middle Name:SINGH
Last Name:JAGPAL
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 1:2635 G ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2813
Mailing Address - Country:US
Mailing Address - Phone:661-633-1500
Mailing Address - Fax:661-633-2700
Practice Address - Street 1:465 W PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3320
Practice Address - Country:US
Practice Address - Phone:559-784-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56433207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A564330Medicaid
CAAZ144ZMedicare PIN
CAG98313Medicare UPIN
CAAZ144YMedicare PIN
CAWA56433AMedicare PIN
CAP00358287Medicare PIN
CA00A564330Medicaid