Vangipuram, Gautam

Vangipuram, Gautam is an individual health care provider with primary practice located at 2619 E Colorado Blvd Ste 150 , Pasadena CA 91107-3747. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Vangipuram, Gautam can be contacted via phone (626) 793-4168.

Contact Information

Primary practice address
2619 E Colorado Blvd Ste 150 Pasadena CA 91107-3747
Phone: (626) 793-4168
Fax: (626) 793-6256
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 2019018140 Missouri
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 2019018140 Missouri
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X C173301 California

Profile Details

NPI number 1780052233
LBN Legal business name Vangipuram, Gautam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2015
Last updated Jan 10th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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