Individual
DR. JIWAN P GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14795 JEFFREY RD STE 204, IRVINE, CA 92618-0417
(949) 486-4411
Mailing address
33 MONTGOMERY, MISSION VIEJO, CA 92692-5115
(949) 648-3878
(949) 486-4417
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A37323
CA
208D00000X
General Practice Physician
Primary
A37323
CA
261QX0100X
Occupational Medicine Clinic/Center
A37323
CA
Other
Enumeration date
08/31/2005
Last updated
05/13/2021
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