Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | A29545 | CA |
NPI | 1649287004 |
---|---|
Provider Name | Dr. Satish Steve Gupta |
First Address | La Canada, CA 91011-1457 |
Second Address | La Canada, CA 91011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 18/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A25805 | (02) | CA |