Provider Demographics
NPI:1164612081
Name:SATISH GUPTA MD INC
Entity Type:Organization
Organization Name:SATISH GUPTA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SATISH
Authorized Official - Middle Name:STEVE
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-249-7200
Mailing Address - Street 1:2258 FOOTHILL BLVD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-1457
Mailing Address - Country:US
Mailing Address - Phone:818-249-7200
Mailing Address - Fax:818-249-7210
Practice Address - Street 1:2258 FOOTHILL BLVD
Practice Address - Street 2:SUITE #100
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-1457
Practice Address - Country:US
Practice Address - Phone:818-249-7200
Practice Address - Fax:818-249-7210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29545207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty