Provider Demographics
NPI:1205957396
Name:VAKHARIA, KALPESH TARUN (MD)
Entity type:Individual
Prefix:
First Name:KALPESH
Middle Name:TARUN
Last Name:VAKHARIA
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 1:11 PARK DR
Mailing Address - Street 2:APT 12
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-4404
Mailing Address - Country:US
Mailing Address - Phone:909-964-6700
Mailing Address - Fax:
Practice Address - Street 1:11 PARK DR
Practice Address - Street 2:APT 12
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-4404
Practice Address - Country:US
Practice Address - Phone:909-964-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229014208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery