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Individual

BRIJ GUPTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2001 4TH AVE, SAN DIEGO, CA 92101-2303
(858) 720-0493
(858) 636-2210
Mailing address
2001 4TH AVE, SAN DIEGO, CA 92101-2303
(858) 720-0493
(858) 636-2210

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A43950
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
W22546
MEDICARE GROUP PTAN
CA
Enumeration date
08/05/2006
Last updated
05/05/2017
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