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General NPI Number Information
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NPI Number | 1902120488
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Entity Type | Organization
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Legal Business Name | SUNEET K GUPTA INC
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Dates
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Enumeration Date | 03/26/2010
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 3233 GRAND AVE SUITE M
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City | CHINO HILLS
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State | CA
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Zip | 91709-1489
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Country | US
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Telephone | 909-591-2034
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Fax | 909-591-2176
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Provider Business Mailing Address
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Address Line | 3233 GRAND AVE SUITE M
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City | CHINO HILLS
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State | CA
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Zip | 91709-1489
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Country | US
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Telephone | 909-591-2034
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Fax | 909-591-2176
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Authorized Official
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Title or Position | OWNER
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Name | SUNEET GUPTA
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Credential | OD
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Telephone | 909-591-2034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 11457 TPL
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License Number State | CA
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