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General NPI Number Information
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NPI Number | 1114458775
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Entity Type | Individual
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Provider Name | JOSHUA GUNPAT
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Gender | Male
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 10039 VINE ST
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City | LAKESIDE
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State | CA
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Zip | 92040-3120
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Country | US
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Telephone | 833-867-4642
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Fax |
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Provider Business Mailing Address
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Address Line | 525 OLIVE ST APT 812
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City | SAN DIEGO
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State | CA
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Zip | 92103-6341
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D89395
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101272132
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD049150
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License Number State | DC
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 191201
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License Number State | CA
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