MEDICARE: VIKAS 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	207RH0003X	Hematology & Oncology Physician	MD 426170	PA
2	207RH0003X	Hematology & Oncology Physician	11822	NV

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	:	1770526964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIKAS GUPTA MD

Provider Business Mailing Address
First Line	:	400 N STEPHANIE ST STE 300
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-6692
Country	:	US
Telephone Number	:	702-952-3350
Fax Number	:	702-952-3365

Provider Business Practice Location Address
First Line	:	9280 W SUNSET RD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4861
Country	:	US
Telephone Number	:	702-952-1251
Fax Number	:	702-952-1242

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	02/29/2024

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Directions to “ VIKAS GUPTA MD” Practice Location

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