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NPI Code Detail

MEDICARE: POOJA GUPTA PT

MEDICARE: POOJA GUPTA PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist291265CA
2225100000XPhysical Therapist

General Provider Information

NPI Number : 1275793614
Entity Type Code : Individual
Provider Name (Legal Business Name) : POOJA GUPTA PT
Provider Business Mailing Address
First Line : PO BOX 1295
Second Line :
City : VENICE
State : CA
Zip : 90294-1295
Country : US
Telephone Number : 888-859-0145
Fax Number : 885-858-1601
Provider Business Practice Location Address
First Line : 6080 CENTER DR FL 6
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-9205
Country : US
Telephone Number : 888-859-0145
Fax Number : 888-858-1601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2008
Last Update Date : 10/14/2022

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Directions to “ POOJA GUPTA PT” Practice Location

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