Individual provider Active NPI

Bharath Raghukultilak, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Bakersfield, CA
National Provider Identifier
1669785846
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
113598 Issued in CA
Practice address
1430 Truxtun Ave Ste 400
Bakersfield, CA 93301-5220
Phone
(661) 635-3050
Fax
(661) 635-3070
NPI assigned
Jul 16, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 274793 NY
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 113598 CA Primary

Addresses

Primary practice location

1430 Truxtun Ave Ste 400
Bakersfield, CA 93301-5220

Mailing address

PO Box 1559
Bakersfield, CA 93302-1559
Phone (661) 635-3050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
113598CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1669785846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933021559",
            "telephone_number": "661-635-3050",
            "fax_number": "661-635-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 TRUXTUN AVE STE 400",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933015220",
            "telephone_number": "661-635-3050",
            "fax_number": "661-635-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHUKULTILAK",
        "first_name": "BHARATH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-16",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "274793",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "113598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.