Healthcare Provider Details

I. General information

NPI: 1306469598
Provider Name (Legal Business Name): ROHIT GUPTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2020
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date: 01/18/2022
Reactivation Date: 02/08/2022

III. Provider practice location address

4860 Y ST STE 100
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

4860 Y ST STE 100
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2737
  • Fax:
Mailing address:
  • Phone: 916-734-2737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA195517
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351046260
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: