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Individual

DAVID CUPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3939 J ST, SUITE 106, SACRAMENTO, CA 95819-3636
(916) 454-4861
(916) 454-3603
Mailing address
3939 J ST, SUITE 104, SACRAMENTO, CA 95819-3636
(916) 454-4861
(916) 454-3603

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
A120754
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
A120754
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0A1207540
CA
Enumeration date
08/08/2008
Last updated
04/03/2017
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