Individual
ANUPAM GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7117 BROCKTON AVE, RIVERSIDE, CA 92506-2615
(951) 782-3789
(951) 784-3275
Mailing address
7117 BROCKTON AVE, RIVERSIDE, CA 92506-2658
(951) 782-3789
(951) 784-3275
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A84431
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A844310
—
CA
01
—
1730180415
GROUP NPI
CA
01
—
ZZZ31887Z
GROUP PTAN
CA
Enumeration date
11/13/2006
Last updated
04/14/2025
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