Provider Demographics
NPI:1073566261
Name:GUPTA, NIRAJ PRASAD (MD)
Entity Type:Individual
Prefix:DR
First Name:NIRAJ
Middle Name:PRASAD
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NIRAJ
Other - Middle Name:PRASAD
Other - Last Name:GUPTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:31764 CASINO DR STE 300
Mailing Address - Street 2:RIVERSIDE COUNTY MENTAL HEALTH
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-4571
Mailing Address - Country:US
Mailing Address - Phone:951-471-4645
Mailing Address - Fax:951-471-4687
Practice Address - Street 1:31764 CASINO DR STE 300
Practice Address - Street 2:RIVERSIDE COUNTY MENTAL HEALTH
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-4571
Practice Address - Country:US
Practice Address - Phone:951-471-4645
Practice Address - Fax:951-471-4687
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA929432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry