MEDICARE: NUPUR GUPTA D.O.

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	2020-00555	NC
2	207RI0200X	Infectious Disease Physician	OS019820	PA
3	390200000X	Student in an Organized Health Care Education/Training Program

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417375940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NUPUR GUPTA D.O.

Provider Business Mailing Address
First Line	:	3100 SUMMIT ST, 2ND FLOOR
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94609-3412
Country	:	US
Telephone Number	:	510-869-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 SUMMIT ST, 2ND FLOOR
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94609-3412
Country	:	US
Telephone Number	:	510-869-8400
Fax Number	:

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

Provider Enumeration Date	:	04/01/2014
Last Update Date	:	01/15/2026

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Directions to “ NUPUR GUPTA D.O.” Practice Location

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