Organization
ANIL GUPTA MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANIL GUPTA MD (EXECUTIVE OFFICER)
(626) 918-1569
Entity
Organization
Contact information
Practice address
1535 W MERCED AVE STE 301, WEST COVINA, CA 91790-3404
(626) 922-0533
(626) 918-2517
Mailing address
417 E MERCED AVE, WEST COVINA, CA 91790-5023
(626) 918-1569
(626) 918-2517
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A46009
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A460090
—
CA
01
—
W20855
PTAN
CA
Enumeration date
03/06/2007
Last updated
04/11/2023
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