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Individual

SAMIR GUPTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3350 LA JOLLA VILLAGE DR, SAN DIEGO, CA 92161-0002
(858) 552-8585
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A78715
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
183520901
TX
01
A78715
MEDICAL BOARD OF CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
08/30/2006
Last updated
12/21/2017
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