Healthcare Provider Details

I. General information

NPI: 1063790632
Provider Name (Legal Business Name): SAPNA RAISONI GUPTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SAPNA JAYPRAKASH RAISONI M.D.

II. Dates (important events)

Enumeration Date: 07/29/2011
Last Update Date: 07/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 GUERRERO ST
SAN FRANCISCO CA
94110-2933
US

IV. Provider business mailing address

1140 GUERRERO ST
SAN FRANCISCO CA
94110-2933
US

V. Phone/Fax

Practice location:
  • Phone: 415-875-9058
  • Fax:
Mailing address:
  • Phone: 415-875-9058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number00047406
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: