Healthcare Provider Details

I. General information

NPI: 1699828129
Provider Name (Legal Business Name): KAMLESH GUPTA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 IRVING ST NW STE 422 POB SOUTH TOWER
WASHINGTON DC
20010-2927
US

IV. Provider business mailing address

106 IRVING ST NW STE 422 POB SOUTH TOWER
WASHINGTON DC
20010-2927
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-0698
  • Fax: 202-877-6959
Mailing address:
  • Phone: 202-877-0698
  • Fax: 202-877-6959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberD0020974
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: