Provider Demographics
NPI:1649287004
Name:GUPTA, SATISH STEVE (MD)
Entity type:Individual
Prefix:DR
First Name:SATISH
Middle Name:STEVE
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:S. STEVE
Other - Middle Name:
Other - Last Name:GUPTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
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
Practice Address - Country:US
Practice Address - Phone:818-249-7200
Practice Address - Fax:818-249-7210
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29545207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA25805Medicare UPIN