Healthcare Provider Details
I. General information
NPI: 1831171735
Provider Name (Legal Business Name): ARIKA GUPTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/16/2005
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5437 KIETZKE LN
RENO NV
89511-1088
US
IV. Provider business mailing address
5437 KIETZKE LN
RENO NV
89511-1088
US
V. Phone/Fax
- Phone: 775-322-4550
- Fax: 775-322-4956
- Phone: 775-322-4550
- Fax: 775-322-4956
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | 11407 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: