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Contact Information

DIPENDRA GAUTAM
502 TRAVERSE DR S
MADERA, CA93636
 Phone: 703-626-9334
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatrics

2251G0304X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for DIPENDRA GAUTAM · (Male)

NPI Number 1437879624
Status Active
Credentials
Entity Individual
Enumeration date 08/30/2022
Last updated 06/08/2025 - About 12 months ago
Sole proprietor 1 No
Identifiers
  • CA License # PT298252
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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