Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 155105 | CA |
N | 207RI0200X | Infectious Disease | 229248 | NY |
NPI | 1063510857 |
---|---|
Provider Name | Jyoti Gupta |
First Address | Fremont, CA 94539-4796 |
Second Address | Fremont, CA 94538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 15/09/2018 |