Basic Information
Provider Information
NPI: 1598184822
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUPTA
FirstName: ARNAV
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1400 JACKSON ST
Address2:  
City: DENVER
State: CO
PostalCode: 802062761
CountryCode: US
TelephoneNumber: 3033884461
FaxNumber: 3033981211
Practice Location
Address1: 1400 JACKSON ST
Address2:  
City: DENVER
State: CO
PostalCode: 802062761
CountryCode: US
TelephoneNumber: 3033884461
FaxNumber: 3033981211
Other Information
ProviderEnumerationDate: 04/15/2014
LastUpdateDate: 06/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200XDR.0058610CON Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
208M00000XDR.0058610CON Allopathic & Osteopathic PhysiciansHospitalist 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207RP1001XDR.0058610COY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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