Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 000000G83863 | CA |
NPI | 1285714337 |
---|---|
Provider Name | Ranjan Gupta |
First Address | Los Angeles, CA 90051-3228 |
Second Address | Orange, CA 92868 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 07/12/2007 |