Provider Demographics
NPI:1093230690
Name:GUPTA, RICHA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RICHA
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9225 TWIN TRAILS DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2692
Mailing Address - Country:US
Mailing Address - Phone:858-538-8770
Mailing Address - Fax:
Practice Address - Street 1:9225 TWIN TRAILS DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-2692
Practice Address - Country:US
Practice Address - Phone:858-538-8770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-04
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69912183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist