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General NPI Number Information
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NPI Number | 1154207454
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Entity Type | Individual
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Provider Name | BIBEKANAND GUPTA NP
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Gender | Male
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 2800 BENEDICT DR
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City | SAN LEANDRO
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State | CA
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Zip | 94577-6840
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Country | US
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Telephone | 510-708-0415
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Fax |
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Provider Business Mailing Address
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Address Line | 4424 ACTRIZ PL
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City | MARTINEZ
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State | CA
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Zip | 94553-1456
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Country | US
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Telephone | 510-708-0415
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP95035684
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | NP95035684
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | NP95035684
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License Number State | CA
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