MEDICARE: DR. ISHA GUPTA MD

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
1	207R00000X	Internal Medicine Physician	49904	AZ

General Provider Information

NPI Number	:	1255598744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ISHA GUPTA MD

Provider Business Mailing Address
First Line	:	14815 N DEL WEBB BLVD
Second Line	:
City	:	SUN CITY
State	:	AZ
Zip	:	85351-2145
Country	:	US
Telephone Number	:	623-977-3300
Fax Number	:	623-977-6808

Provider Business Practice Location Address
First Line	:	14815 N DEL WEBB BLVD
Second Line	:
City	:	SUN CITY
State	:	AZ
Zip	:	85351-2145
Country	:	US
Telephone Number	:	623-977-3300
Fax Number	:	623-977-6808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	10/22/2015

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