Provider Demographics
NPI:1881838605
Name:UBHAYAKAR, KIRAN MADHAV (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRAN
Middle Name:MADHAV
Last Name:UBHAYAKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1100 TRANCAS ST STE 250
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2909
Mailing Address - Country:US
Mailing Address - Phone:707-253-1135
Mailing Address - Fax:707-253-1251
Practice Address - Street 1:913 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CALISTOGA
Practice Address - State:CA
Practice Address - Zip Code:94515-1433
Practice Address - Country:US
Practice Address - Phone:707-942-6233
Practice Address - Fax:707-942-6382
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA146047207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty