Individual
DR. SUNIL GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
26538 MOULTON PKWY STE 38E, LAGUNA HILLS, CA 92653
(949) 448-0656
Mailing address
26538 MOULTON PKWY STE 38E, LAGUNA HILLS, CA 92653-8232
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A12640
CA
207R00000X
Internal Medicine Physician
OT012678
PA
207RR0500X
Rheumatology Physician
Primary
20A12640
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437310059
MEDI-CAL
CA
Enumeration date
06/17/2008
Last updated
07/19/2018
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