Provider Demographics
NPI:1760724371
Name:GUPTA, OPAL KAMDAR (MD)
Entity Type:Individual
Prefix:DR
First Name:OPAL
Middle Name:KAMDAR
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:OPAL
Other - Middle Name:
Other - Last Name:KAMDAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:450 SUTTER ST RM 933
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-3997
Mailing Address - Country:US
Mailing Address - Phone:415-362-5443
Mailing Address - Fax:
Practice Address - Street 1:450 SUTTER ST RM 933
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108
Practice Address - Country:US
Practice Address - Phone:415-362-5443
Practice Address - Fax:415-362-5444
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036140728208000000X
CAA154818207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics