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NPI Code Detail

MEDICARE: JOSHUA GUNPAT

MEDICARE:   JOSHUA  GUNPAT
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
1207Q00000XFamily Medicine PhysicianD89395MD
2207Q00000XFamily Medicine Physician0101272132VA
3207Q00000XFamily Medicine PhysicianMD049150DC
4390200000XStudent in an Organized Health Care Education/Training Program
5207Q00000XFamily Medicine Physician191201CA

General Provider Information

NPI Number : 1114458775
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA GUNPAT
Provider Business Mailing Address
First Line : 525 OLIVE ST APT 812
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-6341
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10039 VINE ST
Second Line :
City : LAKESIDE
State : CA
Zip : 92040-3120
Country : US
Telephone Number : 833-867-4642
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2017
Last Update Date : 02/04/2025

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Directions to “ JOSHUA GUNPAT ” Practice Location

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