Provider Demographics
NPI:1295927911
Name:JAIN, VIPUL VINOD (MD)
Entity type:Individual
Prefix:
First Name:VIPUL
Middle Name:VINOD
Last Name:JAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:2335 E KASHIAN LN STE 280
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2211
Practice Address - Country:US
Practice Address - Phone:559-256-5130
Practice Address - Fax:559-485-4504
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2025-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA88214207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine