Individual
CARMEN VALERIA GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10243 GENETIC CENTER DR, SAN DIEGO, CA 92121-6310
(858) 499-2704
Mailing address
10243 GENETIC CENTER DR, SAN DIEGO, CA 92121-6310
(858) 499-2704
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A124838
CA
207Q00000X
Family Medicine Physician
P4173
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308215801
—
TX
Enumeration date
07/12/2008
Last updated
09/03/2013
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