Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 55992 | CA |
NPI | 1003384520 |
---|---|
Provider Name | Ashna Gupta |
First Address | Encinitas, CA 92024-5008 |
Second Address | Encinitas, CA 92024-5008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2018 |
Last Update Date | 27/09/2021 |