Basic Information
| Provider Information | |||||||||
| NPI: | 1598078545 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | GUPTA | ||||||||
| FirstName: | RUCHI | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 35540 MONTERRA TER | ||||||||
| Address2: | UNIT 101 | ||||||||
| City: | UNION CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945878052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103786524 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3200 KEARNEY ST | ||||||||
| Address2: | BUILDING 1 &2 | ||||||||
| City: | FREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945382299 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104901222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2010 | ||||||||
| LastUpdateDate: | 02/28/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | A119612 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.