Provider Demographics
NPI:1225569379
Name:UDIPI, ASHUTOSH HEGDE (MD)
Entity type:Individual
Prefix:
First Name:ASHUTOSH
Middle Name:HEGDE
Last Name:UDIPI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5530 BIRDCAGE ST STE 145
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7690
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:6501 COYLE AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0306
Practice Address - Country:US
Practice Address - Phone:916-537-5000
Practice Address - Fax:916-851-2884
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-21
Last Update Date:2021-08-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA173109207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology