# DR. JIWAN P GUPTA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1053305458
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | A37323 | CA | — |
| 208D00000X | General Practice Physician | A37323 | CA | Yes |
| 261QX0100X | Occupational Medicine Clinic/Center | A37323 | CA | — |

## Other

- **Enumeration date:** 08/31/2005
- **Last updated:** 05/13/2021