Provider Demographics
NPI:1770528499
Name:RITHAPORN, YOOPPADEE (MD)
Entity type:Individual
Prefix:DR
First Name:YOOPPADEE
Middle Name:
Last Name:RITHAPORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1743 N FRESNO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93703-3031
Mailing Address - Country:US
Mailing Address - Phone:559-233-1188
Mailing Address - Fax:559-443-5200
Practice Address - Street 1:1743 N FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-3031
Practice Address - Country:US
Practice Address - Phone:559-233-1188
Practice Address - Fax:559-443-5200
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A342970174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA27441Medicare UPIN