MEDICARE: DR. SACHIN S 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	207L00000X	Anesthesiology Physician	A113686	CA

General Provider Information

NPI Number	:	1275777237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SACHIN S GUPTA MD

Provider Business Mailing Address
First Line	:	1228 S SALTAIR AVE
Second Line	:	APT 4
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-6642
Country	:	US
Telephone Number	:	310-350-7007
Fax Number	:

Provider Business Practice Location Address
First Line	:	1228 S SALTAIR AVE
Second Line	:	APT 4
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-6642
Country	:	US
Telephone Number	:	310-350-7007
Fax Number	:

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

Provider Enumeration Date	:	04/21/2009
Last Update Date	:	04/11/2013

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