Provider Demographics
NPI:1467157040
Name:SOMPURA, ACHYUT UPENDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ACHYUT
Middle Name:UPENDRA
Last Name:SOMPURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 TREASURE DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-2055
Mailing Address - Country:US
Mailing Address - Phone:858-220-1328
Mailing Address - Fax:
Practice Address - Street 1:220 TREASURE DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2055
Practice Address - Country:US
Practice Address - Phone:858-220-1328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program