Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A104116 | CA |
N | 208600000X | Surgeon | A104116 | CA |
Y | 2086S0129X | Vascular Surgeon | A104116 | CA |
NPI | 1083854582 |
---|---|
Provider Name | Dr. Ankur Gupta |
First Address | Los Altos, CA 94024-0672 |
Second Address | Long Beach, CA 90806-2702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2009 |
Last Update Date | 02/11/2020 |