Provider Demographics
NPI:1780172775
Name:BHUPATHI, VIVEK RAO (MD)
Entity type:Individual
Prefix:DR
First Name:VIVEK
Middle Name:RAO
Last Name:BHUPATHI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2333 MOWRY AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1626
Mailing Address - Country:US
Mailing Address - Phone:510-796-0222
Mailing Address - Fax:510-796-7760
Practice Address - Street 1:2333 MOWRY AVE STE 300
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1626
Practice Address - Country:US
Practice Address - Phone:510-796-0222
Practice Address - Fax:510-796-7760
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2021-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA173671207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA173671OtherCA LICENSE