Individual
RAVI GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2075 W PECOS RD, SUITE#2, CHANDLER, AZ 85224-5693
(480) 289-4550
(602) 765-9513
Mailing address
2075 W PECOS RD STE 2, CHANDLER, AZ 85224-5723
(480) 219-6840
(480) 219-6841
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33007
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
866965
—
AZ
01
—
P00271516
RAIL ROAD MEDICARE ID
AZ
Enumeration date
02/27/2006
Last updated
10/11/2011
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