Healthcare Provider Details

I. General information

NPI: 1760303184
Provider Name (Legal Business Name): RAVI GUPTA M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8737 VAN NUYS BLVD UNIT A
PANORAMA CITY CA
91402-2401
US

IV. Provider business mailing address

8737 VAN NUYS BLVD UNIT A
PANORAMA CITY CA
91402-2401
US

V. Phone/Fax

Practice location:
  • Phone: 818-810-6429
  • Fax: 818-810-6479
Mailing address:
  • Phone: 818-810-6429
  • Fax: 818-810-6479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: RAVI GUPTA
Title or Position: CARDIOLOGIST
Credential: MD
Phone: 818-810-6429