Healthcare Provider Details

I. General information

NPI: 1811304462
Provider Name (Legal Business Name): ROHAN GUPTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2014
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

568 E HERNDON AVE STE 102
FRESNO CA
93720-2989
US

IV. Provider business mailing address

568 E HERNDON AVE STE 102
FRESNO CA
93720-2989
US

V. Phone/Fax

Practice location:
  • Phone: 559-221-7500
  • Fax:
Mailing address:
  • Phone: 559-221-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA145462
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: