Provider Demographics
NPI:1932399441
Name:ARUNA GUPTA, MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ARUNA GUPTA, MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-787-7753
Mailing Address - Street 1:PO BOX 20293
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92516-0293
Mailing Address - Country:US
Mailing Address - Phone:951-787-7753
Mailing Address - Fax:
Practice Address - Street 1:6850 BROCKTON AVENUE
Practice Address - Street 2:SUITE # 108
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3816
Practice Address - Country:US
Practice Address - Phone:951-787-7753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88415207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A884150OtherMEDI-CAL
CA00A884150OtherMEDI-CAL