Provider Demographics
NPI:1598806390
Name:GUPTA, VINEET (MD)
Entity Type:Individual
Prefix:DR
First Name:VINEET
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 PLUMAS BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-5075
Mailing Address - Country:US
Mailing Address - Phone:530-674-2434
Mailing Address - Fax:530-674-2704
Practice Address - Street 1:481 PLUMAS BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-5075
Practice Address - Country:US
Practice Address - Phone:530-674-2434
Practice Address - Fax:530-674-2704
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96761207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00773706OtherMEDICARE RAILROAD
CA00A967610OtherBLUE SHIELD PIN #
CABY113YOtherMEDICARE PTAN - RIDEOUT MEMORIAL HOSPITAL
CABY113ZOtherMEDICARE PTAN - YUBA CITY PRIMARY CARE AND DIABETES 2 CLINIC, INC.
CA1598806390Medicaid
CABY113YOtherMEDICARE PTAN - RIDEOUT MEMORIAL HOSPITAL