Provider Demographics
NPI:1396309639
Name:AMITA UPADHYAY MD INC.
Entity type:Organization
Organization Name:AMITA UPADHYAY MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMITA
Authorized Official - Middle Name:
Authorized Official - Last Name:UPADHYAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-786-6727
Mailing Address - Street 1:508 GIBSON DR STE 270
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5795
Mailing Address - Country:US
Mailing Address - Phone:916-786-6727
Mailing Address - Fax:916-786-6748
Practice Address - Street 1:508 GIBSON DR STE 270
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-5795
Practice Address - Country:US
Practice Address - Phone:916-786-6727
Practice Address - Fax:916-786-6748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty