MEDICARE: MONIKA GUPTA

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	A105120	CA

General Provider Information

NPI Number	:	1417194234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIKA GUPTA

Provider Business Mailing Address
First Line	:	7370 N PALM AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-5782
Country	:	US
Telephone Number	:	559-228-4222
Fax Number	:

Provider Business Practice Location Address
First Line	:	7370 N PALM AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-5782
Country	:	US
Telephone Number	:	559-228-4222
Fax Number	:	559-228-4299

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

Provider Enumeration Date	:	01/15/2009
Last Update Date	:	06/15/2016

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Directions to “ MONIKA GUPTA ” Practice Location

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