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NPI Code Detail

MEDICARE: MR. KINSHUK GUPTA M.P.T.

MEDICARE: MR. KINSHUK GUPTA M.P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist25904CA

General Provider Information

NPI Number : 1033314687
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KINSHUK GUPTA M.P.T.
Provider Business Mailing Address
First Line : 6041 CADILLAC AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-1702
Country : US
Telephone Number : 323-857-4338
Fax Number :
Provider Business Practice Location Address
First Line : 4655 RUFFNER ST STE 270
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-2276
Country : US
Telephone Number : 800-787-6787
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2007
Last Update Date : 10/12/2021

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