Individual
DIPENDRA GAUTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
502 TRAVERSE DR S, MADERA, CA 93636
(703) 626-9334
Mailing address
7942 N MAPLE AVE STE 102, FRESNO, CA 93720-0293
(595) 396-4681
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
PT298252
CA
Other
Enumeration date
08/30/2022
Last updated
06/08/2025
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