Individual
RISHI JAY GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD, MBA
Contact information
Practice address
521 PARNASSUS AVE RM C522, SAN FRANCISCO, CA 94143-0440
(415) 476-8226
Mailing address
521 PARNASSUS AVE RM C522, SAN FRANCISCO, CA 94143-0440
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
58357
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
A126825
CA
Other
Enumeration date
12/08/2010
Last updated
05/22/2015
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