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General NPI Number Information
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NPI Number | 1366455784
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Entity Type | Individual
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Provider Name | RAHUL GUPTA MD
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Gender | Male
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 03/03/2008
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Provider Practice Location Address
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Address Line | 945 SHASTA ST
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City | YUBA CITY
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State | CA
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Zip | 95991-4114
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Country | US
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Telephone | 530-674-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 1336 JAMIE DR
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City | YUBA CITY
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State | CA
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Zip | 95993-1183
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Country | US
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Telephone | 530-821-0470
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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 | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | L3671
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License Number State | TX
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