Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A111492 | CA |
N | 111NI0900X | Internist | A111492 | CA |
N | 207R00000X | Internist | ML20008617 | WA |
N | 111NI0900X | Internist | ML20008617 | WA |
Y | 207RX0202X | Medical Oncology | A111492 | CA |
NPI | 1144330416 |
---|---|
Provider Name | Neel Kamal Gupta |
First Address | Stanford, CA 94305-2200 |
Second Address | Seattle, WA 98195-6421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 29/11/2021 |