| Anil Gupta Md Inc | |
|
1535 W Merced Ave Ste 301 West Covina CA 91790-3404 | |
| (626) 922-0533 | |
| (626) 918-2517 |
| Full Name | Anil Gupta Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1535 W Merced Ave Ste 301, West Covina, California |
| Authorized Official Name and Position | Anil Gupta (EXECUTIVE OFFICER) |
| Authorized Official Contact | 6269181569 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anil Gupta Md Inc 417 E Merced Ave West Covina CA 91790-5023 Ph: (626) 918-1569 | Anil Gupta Md Inc 1535 W Merced Ave Ste 301 West Covina CA 91790-3404 Ph: (626) 922-0533 |
| NPI Number | 1821128224 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 04/11/2023 |
| Medicare PECOS PAC ID | 6709982408 |
|---|---|
| Medicare Enrollment ID | O20070716000658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821128224 | NPI | - | NPPES |
| W20855 | Other | CA | PTAN |
| 00A460090 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A46009 (California) | Primary |
| Provider Name | Anil Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538182407 PECOS PAC ID: 6305737982 Enrollment ID: I20061120000257 |
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